Order Reprints

Changes to Medicare and Medicaid could mean more patients will seek out services from Cherry Street Health Services, already one of the region’s largest providers of primary care medical and dental services to low-income patients. PHOTO COURTESY OF CHERRY STREET HEALTH SERVICES

Growing demand drives Cherry Street Health Services expansion, but need far from satisfied

By Daniel Schoonmaker | MiBiz
This e-mail address is being protected from spambots. You need JavaScript enabled to view it

GRAND RAPIDS — Now in the midst of its largest capacity ever, Cherry Street Health Services is on the front lines of healthcare reform in West Michigan. The federally qualified health center is the largest provider of primary care medical and dental services to low-income patients in the region.

Its continued growth could be the largest factor in whether the region ever achieves full access to healthcare, known politically as universal care, if it could ever keep up with the growth in demand.

Between 2000 and 2006, the Cherry Street system increased its annual capacity by 44,000 patients. Over that same period, the number of low-income residents in West Michigan increased by 50,000. Now at 12 locations in Grand Rapids and one in Greenville, Cherry Street has a current total capacity of roughly that many patients. Even with the opening of its new $30 million Heart of the City Health Center next year in downtown Grand Rapids — designed to serve 27,000 patients, 13,500 of which is new capacity — some 40 percent of the 193,000 low income residents in Kent County will still have no access to primary care.

“We’ve grown rapidly and continue to do so as quickly as we can secure funding,” said Chris Shea, executive director of Cherry Street Health Services. “But the number of people who need our services is growing at a much faster rate.”

As has been reported at length in recent years, there are simply not enough primary care physicians interested in taking on new Medicaid patients. There are even fewer willing to take on uninsured patients, which Cherry Street serves on a pay-as-you-can basis. In most cases, the only alternative is hospital emergency rooms, a well-documented blight on healthcare costs. There are no other significant suppliers of Medicaid dental services in the region.

The new Heart of the City Health Center will help alleviate the shortfall. Located at the corner of Sheldon and Cherry Street in Grand Rapids’ Heartside neighborhood, the 79,300-square-foot facility is a collaboration with mental health service providers Touchstone Innovare and Proaction Behavioral Health Alliance, funded through local philanthropy and federal and state grants, including some federal stimulus funds.

The facility represents a new approach to care for low-income populations, integrating medical and behavioral services under one roof. Untreated behavioral conditions are a significant cost driver in low-income patient care and afflict the Medicaid population at a much higher percentage than other patient groups, so this new model will deliver much needed efficiencies to the system. The site will also host a 1,200-patient pilot program for a new integrated care model for chronic illness originally developed for medical conditions and general healthcare.

Both Touchstone Innovare and Proaction will move their headquarters to the site. Cherry Street Health Services will be adding new capacity and consolidating services from its Grand Rapids Pediatrics and Ferguson Adult Health Center clinics.

“The expansion alone is bigger than any of our existing sites in terms of the number of patients we can serve,” said Shea. “This is definitely going to clear up some bottlenecks and gives us the opportunity to improve the quality of our care and provide access to a variety of different populations that we might not have been able to accommodate as well before.”

In addition to the Heart of the City Health Center, Cherry Street is currently in discussions with the Salvation Army to expand their collaborative Booth Family Services clinic, with area hospitals to increase collaboration and potentially further expand capacity, and is investigating a possible new expansion into the city of Wyoming.

Even beyond that, the federal government’s healthcare reform plan could mean the Cherry Street system’s most significant growth is yet to come. The legislation now calls for a massive expansion of Medicaid and the effective doubling of the number of patients served by federally qualified health centers such as Cherry Street over the next five years. That could mean as many as 40,000 new patients in the near future.

“That would be a level of increase far beyond anything we’ve seen before,” said Shea. “We would then have to gather the staff — twice as much staff, search for twice as many people — and that is becoming very scarce. There just aren’t the numbers being educated to completely fill that need.”

Shea said the system is committed to working with national and state partners to ensure the needed personnel, including both primary care physicians and specialists, find their way to Cherry Street. He expects a great deal of that to come from increased funding to the National Health Service Corps, a federal program that provides scholarship and loan repayment to medical professionals in return for two to four years of service in organizations like Cherry Street.

Of equal or greater concern, Shea said, is funding. Medicaid accounts for the majority of the system’s $25 million annual budget, the rest split between other public funding such as Medicare and the Kent Health Plan, commercial insurance, other local healthcare systems and hospitals, grants and cash fees from uninsured patients.

It could not sustain a significant increase in patient capacity on Medicaid reimbursements alone. Plus, Medicaid funding can be fickle, with funding shifting with state or federal priorities and politics. This is particularly true for specialties such as oral health and vision services.

“We will need to be very aggressive in our pursuit of federal funds, which usually come on a competitive basis,” Shea said. “We’ve been extremely aggressive in times when funds have been scarce and have been successful, more so than other systems in other regions. Of course Michigan’s high unemployment and poverty rate helps us make the case for increased funding.”

  Order Reprints

TAGS:

• cherry street health service
• grand rapids
• healthcare