Elrod James K, Fortenberry John L
Willis-Knighton Health System, 2600 Greenwood Road, Shreveport, LA, 71103, USA.
LSU Shreveport, 1 University Place, Shreveport, LA, 71115, USA.
BMC Health Serv Res. 2017 Dec 13;17(Suppl 4):791. doi: 10.1186/s12913-017-2756-4.
Health and medical providers dedicated to serving the poor face daunting challenges, with the most obvious one pertaining to the provision of services with little or no expectation of remuneration. This hardship often is overlooked by broad society as many view the delivery of healthcare services to indigent populations to be covered fully by government health insurance programs or other forms of public assistance. This, however, is only partially true and, even when reimbursements or similar payments are provided, they often fall short of covering the actual costs associated with rendering services.
With reimbursements from third parties often being unreliable, inadequate, and sometimes nonexistent, healthcare providers dedicated to serving poverty-stricken populations face quite a dilemma. As an institution which is devoted to addressing the disadvantaged, Willis-Knighton Health System has long sought remedies to bolster healthcare access for these vulnerable individuals. While public policy solutions ultimately are desired, historic and recent efforts continue to reveal fractures which in some cases have compelled providers to limit their exposure to indigent populations or withdraw from serving them altogether. Willis-Knighton Health System has addressed these challenges by operating as efficiently as possible, offering and successfully delivering a diverse service mix which permits a healthy margin that can support charitable care initiatives, and remaining steadfastly committed to shoring up indigent services in the community.
Given the magnitude, scope, and expenditures associated with comprehensively addressing disadvantaged populations, public policy modifications appear to be the primary hope of remedying associated access gaps fully. Until effective measures are introduced, however, health and medical institutions dedicated to serving the indigent must look within for answers to associated challenges.
致力于为贫困人口提供服务的健康与医疗服务提供者面临着艰巨挑战,其中最明显的挑战之一是在几乎没有或根本没有报酬预期的情况下提供服务。这种困难往往被广大社会所忽视,因为许多人认为为贫困人口提供医疗服务完全由政府医疗保险计划或其他形式的公共援助覆盖。然而,这只是部分正确,即使提供了报销或类似付款,它们往往也不足以支付提供服务的实际成本。
由于第三方报销往往不可靠、不足,有时甚至不存在,致力于为贫困人口提供服务的医疗服务提供者面临着相当大的困境。作为一个致力于解决弱势群体问题的机构,威利斯 - 奈顿健康系统长期以来一直在寻求补救措施,以加强这些弱势群体获得医疗服务的机会。虽然最终需要公共政策解决方案,但历史和近期的努力不断揭示出一些裂痕,在某些情况下,这些裂痕迫使提供者限制与贫困人口的接触或完全退出为他们服务。威利斯 - 奈顿健康系统通过尽可能高效地运营、提供并成功交付多样化的服务组合(这允许有一个健康的利润空间来支持慈善医疗倡议)以及始终坚定地致力于加强社区内的贫困服务来应对这些挑战。
鉴于全面解决弱势群体问题所涉及的规模、范围和支出,公共政策调整似乎是完全弥补相关服务获取差距的主要希望。然而,在引入有效措施之前,致力于为贫困人口提供服务的健康与医疗机构必须从内部寻找应对相关挑战的答案。