Location, Location, Location: A Baby Step to Reducing the Hardship of Health Care Delivery

25 Jul Location, Location, Location: A Baby Step to Reducing the Hardship of Health Care Delivery

calculator-385506_1280By Robert Broadway

Everyone knows what it means to take “baby steps”.  These are the steps that guide us along life’s journey. For many Americans, that footing along the path becomes treacherous when they need to access basic medical care for themselves and their families. While the solution to the financial burden is allusive, healthcare leaders across the country are taking “baby steps” to make it a little easier for everyone. One of those partnerships that started with a few baby steps is now delivering cost effective health care and making a difference in Palm Beach County, Florida.

Bethesda Hospital is a not-for-profit hospital in Palm Beach County, Florida, that has provided quality health services to our community for over 56 years. Genesis Health Center is a Federally Qualified Health Center (FHQC) that had worked with Bethesda for several years. Our joint efforts were initially small, referring patients from our emergency department (ED) to Genesis for follow up care. Genesis offered low cost, quality care and we worked together on an informal way to communicate that patients can set an appointment at the clinic to access care. This seemed simple enough, an ED and a clinic. Basic care delivered with no financial hardship.

All across the country this same situation is taking place at many hospitals and healthcare organizations, but in those same communities, individuals continue to be overwhelmed by the impact of financial and other burdens that revolve around healthcare. When we looked at the number of people actually scheduling primary care follow-up, it was minimal. So we began listening to patients. Many worked and needed after hours appointments. Paying co-pays and deductibles was a major issue. Transportation and location were also barriers. After listening, we began to act. Genesis was located in a shopping center and was losing their lease. We had space on our campus 100 feet from our emergency department. What an opportunity. I worked with our executive team and others to bring Genesis to our hospital campus. Location, location, location.

Genesis relocating to Bethesda opened up many opportunities for collaboration. First, we redirected appropriate level 1 and 2 ED patients to Genesis in real time (location). We developed a more appropriate level of basic care (better care) at a lower cost (sliding fee schedule that is up front and transparent). Patients were already here eliminating the need to schedule a future appointment. And for those return visits, Genesis has evening and weekend hours. We redirected inpatient discharges needing follow-up care to Genesis as they were leaving the building (location). We have an outpatient pharmacy so patients can fill prescription without another trip (location). It’s working.

We have not solved all the issues relating to the financial burden of healthcare. But with our first baby steps we made connections with patients and provided convenient, cost effective care. We continue to listen and have begun the conversation on value.


Robert Broadway’s essay was submitted as part of the 2015 Costs of Care, HFMA, Strata Decision Technology, and Yale New Haven Health’s contest entitled The Best Care, The Lowest Cost – One Idea at a Time.

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