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Marillac Clinic hopes to double its number of patients served

Our decision to become an FQ-CHC, the local need for primary care, Doctors McCrea and Buisker from the Grand Junction Daily Sentinel, March 15, 2016

The Marillac Clinic has posted a sign announcing that they are welcoming new patients and have expanded their services to include prenatal care and pediatics.
 Dr. John Whiteside
Dr. John Whiteside, medical director of the Marillac Clinic, describes the expanded services the clinic now offers at its two sites.

By Melinda Mawdsley
From the Daily Sentinel Monday, March 14, 2016

The message is simple but potentially life-altering for western Colorado: “New Patients Welcome!”

For the first time in its 28-year history, Marillac Clinic has expanded its services and is accepting patients of all ages, including children and seniors, no matter what insurance, if any, they have.

The shift in care to include obstetrics, prenatal, pediatrics and family medicine for seniors, as well as optical and dental services for all ages while still treating adults 18 to 64, is a direct result of the clinic being named a federally qualified health center in May 2015.

Marillac’s board of directors made the decision to apply for such designation in October 2014 in a sort of crossroads moment: the realization that the ongoing recession was keeping the clinic’s primary source of income — grants — in limbo and that implementing the Affordable Care Act would drop the rate of uninsured while increasing the population on Medicaid.

Marillac has always served the under-insured and uninsured of Mesa County, but the designation paved the way for annual federal grant funding from the U.S. Department of Health and Human Services.

It also meant a significant bump in the reimbursement rate for treating Medicaid and Medicare patients, while also ensuring Marillac offered a sliding fee discount program based on need.

When Marillac learned it achieved FQHC status it set in motion a swift change to serve all ages at or below 200 percent of the federal poverty line.

To be at the 200 percent federal poverty line in 2015, annual income was $23,540 for an individual and $48,500 for a family of four. People get closer to qualifying for Medicaid as annual income drops.

Marillac hired new physicians and announced that the clinic was accepting new patients, offering comprehensive primary and preventative care from birth to death, or before in the case of prenatal patients.

Prior to 2015, Marillac did not see any Medicare patients and a limited number of Medicaid patients.

“When it comes to families under 200 percent poverty level, a great deal of their health, and one of the largest determinants of their health, is social — getting transportation to regular medical care, language barriers, where they live, exposure to toxins,” said Dr. John Whiteside, chief medical officer at Marillac.

When barriers to accessing health care are put up, including ability to pay or ability to find a physician who will take certain insurance, patients either won’t seek treatment or will use emergency rooms as doctor offices, Whiteside said.

“If we’re successful, it will be transformative to Mesa County in that all of a sudden, these working poor families actually have access to high quality care,” he said. “We are taking on new patients very quickly and growing very fast. We are seeing a bunch of adolescents who have never had an immunization shot in their life.”

Marillac’s push to become financially sustainable and expand services is because the need to serve the uninsured and under-insured is real.

According to the Mesa County Health Department, approximately 33 percent of county residents live below 200 percent of the federal poverty line. In Colorado, that rate is 29 percent.

More than 45,200 Mesa County residents are on Medicaid and more than 1,700 children are CHP+ members, the Colorado Department of Health Care Policy & Financing reported at the end of January.

Last year, that same department showed the rate of under-insured in the county was 22 percent, up from 15.6 percent in 2013.

The call to provide medical services to this population is why Whiteside took the job in 2014, even though the future of Marillac at that time was unclear.

Since the FQHC designation, Marillac has hired three doctors and three nurse practitioners on top of the dental and optical services already in place.

Two of those doctors, Dr. Katie McCrea and Dr. Elizabeth Buisker, joined Marillac in August.

McCrea knew Whiteside from his time as associate director of St. Mary’s Family Residency Program. After her residency at St. Mary’s, McCrea went to New Zealand to work around universal health care.

When she heard Whiteside accepted a position at Marillac and learned about the changes the clinic had implemented, she was in.

“I enjoy taking care of children and the whole family,” McCrea said. “That fact that we can do that is really exciting.”

Buisker, on the other hand, spent several years in Meeker, practicing medicine in a rural setting before moving to Grand Junction. She did her residency in Denver.

“I’m super excited to be involved at this point, knowing all the changes you are going to be in the middle of and having a real say in,” Buisker said.

Last year, Marillac saw 5,600 people between its primary location on Sixth Street and its clinic at the Mesa County Health Department, 510 29 1/2 Road.

This year, Whiteside said Marillac’s providers want to see 11,000 patients.

Doubling in size in one year is bold, but Whiteside said Marillac already is looking to add staff and offer more services at its Health Department location due to demand.

“It really is herculean and amazing how much we’ve done in a year,” he said. “We had hoped we would be selected as a federally qualified health center, and it is pretty phenomenal that we were selected. There were 700 practices or so that started the application process. Of the 140 awarded, 120 of them were only for extensions. There are 20 new sites, and Marillac was one of them.”

Marillac’s primary location at 2333 N. Sixth St. is open from 8 a.m. to 5 p.m. Monday through Wednesday and Friday and from 10 a.m. to 9 p.m. on Thursday. That clinic can be reached at 298-1782.

The county clinic is open 8 a.m. to 5 p.m. Monday through Wednesday and Friday and 10 a.m. to 5 p.m. on Thursday. It can be reached at 298-1782.