Case Studies
Providing OB-GYN Care and Medical Homes through FQHC Partnerships
Holy Cross Hospital could be characterized as an emergency department with critical care units. The hospital sees about 45,000 visits annually in its ED, with by far the highest number of ambulance runs in the state of Illinois, about 60 per day. Acuity of its patients is high, averaging almost 1.4 for its Medicare patients, despite doing little surgery. The problem was the lack of a viable primary care network in the community. Because of the payer mix of the community, the hospital did not expect new physicians to acquire the practices of retiring physicians. In addition, the demands on private practitioners no longer support the solo practice model, and physician groups were unlikely to come to an area where reimbursement was so problematic. A second issue was the suspension of labor and delivery; the unit had to be reopened both for community service reasons and because it was a requirement of the disproportionate share funding on which the hospital was heavily dependent.
Holy Cross Hospital could be characterized as an emergency department with critical care units. The hospital sees about 45,000 visits annually in its ED, with by far the highest number of ambulance runs in the state of Illinois, about 60 per day. Acuity of its patients is high, averaging almost 1.4 for its Medicare patients, despite doing little surgery. The problem was the lack of a viable primary care network in the community. Because of the payer mix of the community, the hospital did not expect new physicians to acquire the practices of retiring physicians. In addition, the demands on private practitioners no longer support the solo practice model, and physician groups were unlikely to come to an area where reimbursement was so problematic. A second issue was the suspension of labor and delivery; the unit had to be reopened both for community service reasons and because it was a requirement of the disproportionate share funding on which the hospital was heavily dependent.
Hospital officials sought out a large federally qualified health center, one that had some sites already operating in the periphery of the hospital's service area. With the assistance of a federal Emergency Department Diversion grant, funneled through the state of Illinois, the FQHC opened a primary care site on the campus of the Holy Cross in fall of 2009.