An Arizona Hospital and Healthcare Association community benefits study revealed that Arizona's hospitals together reached more than 1.5 million of the state's residents, approximately 25 percent of the population, with programs for underserved and uninsured Arizonans as well as other residents.

Memorial Health University Medical Center’s Medical Respite Care Program was created in collaboration with the JC Lewis Health Center, a local federally qualified health center, to provide acute and post-acute medical care for homeless individuals presenting at the emergency department. The program was designed to assist homeless individuals who are too ill or frail to be on the streets, but are not ill enough to require hospitalization. Beds are available at all times, with care and oversight provided by a nurse practitioner and physician.

Northwestern Memorial Hospital’s Diabetes Collaborative is a partnership among the hospital, medical school and two federally qualified health centers.  It grew out of a critical need for assistance to combat the health problems associated with diabetes in two underserved Chicago neighborhoods.  The collaborative helps identify and teach adult patients with Type 2 diabetes how to manage their chronic condition. The program uses culturally sensitive bilingual videos and print materials to help patients of all education levels self-manage their diabetes.

Ephraim McDowell Regional Medical Center’s Hope Clinic and Pharmacy is a collaborative that provides free medical services to uninsured, medically underserved residents with pre-determined chronic conditions. The medical center provides administrative oversight, outpatient pharmaceutical support and volunteers.

Working in partnership with MedStar Union Memorial Hospital, Shepherd's Clinic provides quality, comprehensive health care to uninsured and low-income residents in northeast Baltimore. The clinic relies on 350 volunteer physicians, nurses, students and community members. While patients are asked to donate the equivalent of one hour's wage for an office visit-nine dollars-no one is ever turned away because they cannot pay. In 2011, the clinic cared for more than 2,300 patients and had almost 6,500 visits. Additionally, the clinic recently opened the Joy Wellness Center with the goal of empowering patients to take better care of themselves and to make healthy, life-affirming changes. The center offers nutrition education, healing arts, stress reduction and movement education.

Riverside Health System supports Project CARE, a special program for uninsured, low-income residents in the Greater Virginia Peninsula region. Project CARE addresses the need for a regional system of care for uninsured patients utilizing the emergency department as their medical home.  The program pools specialty providers to provide care to the uninsured and to reduce problems associated with chronic disease.

Aurora Medical Center provides support to the only local free clinic in Washington County, the James E. Albrecht Free Clinic. The medical center provides in-kind donations of laboratory tests and X-rays for patients who are referred by the clinic. Additionally, Aurora Health Care employees donate their time to the free clinic, helping ensure that patients have access to care outside the hospital for follow-up, medications, screenings and other preventive services.

Suburban Hospital is committed to assuring access to care for all and does so through a number of programs including its support of the Clinica Proyecto Salud and the Holy Cross Clinic.  Support from Suburban Hospital has allowed these safety net clinics to extend their hours of operations and supplement additional health care providers. In fiscal year 2011, 1,308 under/uninsured patients were provided with $4,000,231 in medical care at Suburban Hospital.

Berkshire Health Systems’ “Get Cuffed Berkshires” is a community-based hypertension program that brings existing outreach and public health services together to organize evidence-based initiatives, including free blood pressure screenings and targeted educational programs, to county residents, especially those at risk. Populations with limited access to care, seniors, the homeless and those with mental illness or disability have an even greater risk. In the first few months of the program, more than 2,500 individuals have been screened.

Saint Francis Health System operates the Xavier Medical Clinic to extend access to physicians, pharmacists, nurses and other health care professionals to those in the community who are uninsured or do not have access to health care services.  During 2011 alone, Xavier Medical Clinic cared for more than 5,000 patients.

Through the “Mammogram 500” program Dixie Regional Medical Center plans to provide 500 free mammograms to screen uninsured women in need.  The goal is to save lives through early detection and routine screening for breast cancer – the leading cause of cancer death amongin Utah women. Southern Utah ranks among the lowest in the nation for eligible women receiving mammograms.

Beebe Medical Center offers free screenings, disease prevention and early diagnosis outreach programs for cancer, diabetes and heart disease. Specialized nurses encourage people to have regular screenings and help people access financial, transportation, translation and other related resources. The nurses have also initiated an “Early Detection Connection” campaign, which reaches out to physicians and offers case management services to their patients who are in need of screenings they cannot afford. Much of their outreach is targeted to minorities, high--risk groups and underserved populations.

Christiana Care Health System sponsors Community Link Health Day in an effort to eliminate disparities in access to health care. Residents and neighbors were LINKed to free and easy access to health screenings and information, including on-site screenings such as HIV and chronic disease screenings that included cholesterol, sugar, and blood pressure. In addition, cancer awareness education and information was made available to attendees.

Baptist Memorial Health Care's Mammography for the Underserved  uses a mobile mammography unit to provide free digital screening mammograms and additional diagnostics as needed, to women from lower socioeconomic neighborhoods who have no other means to receive screenings or breast health care and education.

InovaCares Clinic for Women and Children was established to address specific health care access issues for the uninsured and Medicaid populations in Northern Virginia.

Cook Children's Health Care System began an initiative to address the health needs of more than 1,000 homeless children in Tarrant County. The Cook Children's neighborhood clinics serve as a medical home for underserved and homeless children.

In 2010, Upland Hills Health provided 1,408 people with reduced or entirely forgiven bills, based on their financial situations through the Community Care program. Recipients came from a variety of situations.

Yakima Valley Memorial Hospital's Children's Village is a model of collaborative care with multiple partners providing more than 30 types of health, therapeutic intervention and support services that positively impact outcomes for children with special health or developmental needs and their families regardless of a family's ability to pay. Area children with special needs now have access to high-quality, coordinated services.

Memorial Health University Medical Center's Medical Respite Care Program was created in collaboration with a local federally qualified health center, to provide acute and post-acute medical care for homeless individuals presenting at the emergency department. Beds are available at all times for homeless individuals who are too ill or frail to be on the streets, but are not ill enough to require hospitalization. They receive care and oversight provided by a nurse practitioner and physician.

The Altoona Regional Partnership for Health Services is a free medical clinic to address the primary care needs of the working underinsured or uninsured. In summer 2010, the partnership created a low-cost, hospital-only insurance plan designed to give patients access to surgery, anesthesia and all related inpatient care.

Lourdes Health Network's PATH program (Projects for Assistance in Transition from Homelessness) provides outreach to homeless men and women and connects them with community services such as crisis mental health units and food banks.

Mercy Hospital of Portland established the McAuley Residence to provide a safe environment and comprehensive transitional housing and support program for homeless, at-risk women and children. Services include access to health and dental care; life skills counseling; education about resources available from other community based agencies; and connections to partner organizations with expertise in career exploration, parenting, and childcare issues.

Saint Agnes Medical Center joined the Sisters of the Holy Cross to create Holy Cross Clinic at Poverello House in downtown Fresno to meet the medical needs of the area homeless individuals. The clinic is staffed by a full-time nurse practitioner and medical team composed of volunteers - physicians, dentists, nurses and allied health practitioners, who provide free medical and dental services to the community's uninsured and underinsured.

The clinic provides needed health care to those who would otherwise go without and last year, the clinic received more than 7,900 medical visits and 660 dental visits.

Froedtert Hospital collaborates with a local public school and a federally qualified health center to meet the needs of children living in an underserved neighborhood. The hospital sponsors a school nurse who is able to work with school leadership and community health center staff to meet the basic health needs for 700 students and their families.

Catholic Medical Center's Health Care for the Homeless  (HCH) program is a “clinic without walls” that provides primary medical care, mental health care, nursing case management, addiction counseling, social services and health education to homeless individuals and families on-site at clinics located in shelters and transitional housing programs. The HCH team collaborates with many local health care providers and human service agencies to increase access to health care for more than 1,000 people struggling with homelessness.

Day Kimball Healthcare provides preventive services and cancer treatments such as mammograms, ultrasounds, medications, surgical procedures as well as travel assistance to community residents who need financial assistance. The goal is to provide residents in need with access to appropriate preventive care and/or necessary cancer-related treatment or services.

The newly opened Cleveland Clinic Stephanie Tubb Jones Health Center reaches beyond traditional healthcare services to link with community resources in one location to make it easier for patients and families access the healthcare, social and financial services they need.

Baton Rouge-based Woman's Hospital operates a Mobile Mammography Coach that provides screening for women at 105 locations throughout a 15-parish area. At least 40% of the patients using this coach have no insurance, and in the rural parishes this is as high as 90%. The Woman's Mobile Mammography Coach has been successful in reaching underserved women and collaborating with community-based organizations to reduce geographic and financial barriers to cancer care.

Baptist Health Medical Center developed the Heaven's Loft program to help ensure that low-income expectant mothers and parents of young children received prenatal and well-baby care and attended classes on childbirth, breastfeeding, infant/child care and parenting. For their participation, parents earn vouchers that can be used for needed baby supplies, including cribs, car seats, diapers and other necessities.

Penobscot Bay Medical Center has partnered with a local dentist to help MaineCare patients with acute dental pain access to care and connect with a dentist. Patients with no access to dental care were arriving in the emergency department in pain and often with infections. When discharged, they had temporary solutions with antibiotics and pain medication, but there was no treatment plan or provider with whom to follow up. Now the medical center staff will either make dental appointments or give patients contact information for where they can access follow-up dental care.

Berkshire Medical Center created the Community Outreach Van program as a way to reach communities where large numbers of individuals were thought to be uninsured. The outreach van is equipped with two state-of-the-art treatment and exam rooms that also provide a confidential space for visitors to discuss insurance eligibility, be screened for health risk factors or referred for other social services.

Froedtert Hospital's Neighborhood School Nurse Initiative is a collaboration among the hospital, a K-8 public school and a federally qualified health center. A hospital-sponsored school nurse works with school leadership and community health center staff to meet basic health needs for 700 students and their families in a medically underserved neighborhood. During the 2008-2009 school year, the school nurse provided 1,285 health visits to students, a series of health education sessions and a health fair.

Catholic Medical Center provides primary medical care, mental health care, nursing case management, addiction counseling, social services and health education to homeless individuals and families on-site at clinics located in shelters and transitional housing programs through their Health Care for the Homeless Program (HCH). The HCH team collaborates with many local health care providers and human service agencies to increase access to health care for more than 1,000 people struggling with homelessness.

Banner Health Sterling Regional MedCenter provides mammograms and screening tests at no cost for uninsured and underinsured women so that cancer can be detected early when it is most treatable. Getting screened regularly for breast cancer is the best way for women to lower their risk of dying from breast cancer. But for many women with limited or no health insurance, regular mammograms are out of reach.

Inova Health System developed the Inova Juniper Program (IJP) to help uninsured and under-insured people living with HIV/AIDS to have access to a full complement of comprehensive health services. IJP staff manage clients through the complete life cycle of their disease, with the goal of enhancing quality of life by helping them to maintain health and delay the onset of disease and disability.

Blue Ridge Regional Hospital (BRRH) in Spruce Pine, N. C. launched the Toe River Project Access (TRPA) to help low-income and uninsured residents gain access to comprehensive health care. TRPA operates in partnership with area physicians, dentists, optometrists and BRRH and has provided 795 uninsured residents with more than $3.5 million in free medical care.

Providence Health & Services in Hawthorne, CA created the Vasek Polak Health Clinic to meet the primary care needs of uninsured and underinsured adults living in the community. The Health Clinic is a direct extension of the organization's mission, providing much-needed care to the poor and vulnerable.

Alaska Native Medical Center in Anchorage provides primary and specialty care clinics in 14 communities across the state, as well as tele-medicine services to 273 sites across six states and three tribal nations. Without this outreach, medical services would not otherwise be available in remote communities throughout the state.

Fairview Health Services based in Minneapolis, partnered with the Bloomington public schools to open the Fairview Pond Center Clinic. The clinic provides low-cost medical, mental health and dental services to area children.

AtalntiCare Regional Medical Center's Special Care Center (SCC) is a primary care medical home practice designed exclusively for low-income patients with chronic conditions and the SCC charges payers or employers a flat monthly fee or a share of the operating cost in order to remove barriers to care for low-income, at-risk individuals.

During the 2009 fiscal year, Mile Bluff Medical Center in Wisconsin was able to help nearly 600 individuals who were unable to pay some or all of their medical bills, about seven of every ten dollars applied for was granted, and over $900,000 of debt was forgiven though the Community Care Program.

Saint Joseph's Mercy Care is one of Atlanta's oldest and largest community outreach programs serving the homeless, uninsured, and underinsured and immigrant populations by "taking health care where it is needed most." Mercy Care provides a system of primary health care, dental care, education, and social services reaching thousands of persons in need throughout Atlanta.

Saint Mary's Regional Medical Center first began using a mobile approach to health care in 1994 when the organization established its first mobile dental program. Since that time, Saint Mary's mobile care has expanded to four robust programs, with four vans serving those most in need of care.

Mercy Iowa City Healthy Kids Community offers free health services to children.

Berkshire Medical Center in Massachusetts community outreach van hits the road every week to provide free health screenings.

Providence Little Company of Mary's Mary Potter Program for Human Dignity was established to help make health care available for the sick within the San Fernando and Santa Clarita Valleys and South Bay regardless of their ability to pay. 

Providence St. Peter Hospital in Washington created CHOICE in 1995, which stands for Consortium of Healthsystems Organized in Collaborative Effort, and was the result of rural hospitals working together to understand state-passed health reform. CHOICE has helped more than 30,000 individuals secure and retain health insurance.

Case Study: Saint Mary's Regional Medical Center - Mobile Health Outreach Programs, Reno, NV

Case Study: Mercy Iowa City - Healthy Kids Community Care, Iowa City, IA

Case Study: Mercy Health System - Community Health Center at Mercy Clinic South, Janesville, WI

Case Study: Altoona Regional Health System - Free Clinic/Hospital-Based Insurance, Altoona, PA

"Caring for Communities" website: More Access & Coverage Case Examples

Uncompensated Care Fact Sheet, December 7, 2010