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“If access to health care is considered a human right, who is considered human enough to have that right? ”
~Paul Farmer, M.D., Ph.D.
Access to Care
A number of components of the PC4You bill are aimed directly at improving patient access to care. The legislation achieves this by incentivizing primary care practices to include the following “Transformers” in their practice. You can read more about these here.
Medical Interpreter Services

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Invest in systems that ensure interpreter services are available to any patients who would benefit
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The use of interpreters in patients with Limited English Proficiency increases the number of prescriptions filled, recommended preventive services completed, and reduces health disparities.
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It is a human right to have access to medical care in one’s own language, as understanding your physician is key to patient autonomy.
Social Determinants of Health Investments

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Investing in services that help patients overcome social determinants of health such as food, transportation, and housing insecurity.
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Overcoming SDOH challenges can directly and indirectly increase access to care.
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A recent survey found only 23% of physicians routinely screen for SDOH.
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Physicians cite the greatest barriers to SDOH screening as being time and resources–with 50% saying they did not have the resources to adequately address SDOH.
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States that have a higher ratio of social to health spending (calculated as total social service spending divided by total medicare and medicaid spending) had better outcomes in multiple major disease measures, such as asthma, type 2 diabetes, and mortality rates for lung cancer in part due to resources designed to increase access to care.
Telehealth

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Invest in infrastructure/technology necessary to offer regular telehealth access to patients
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In a study with elderly patients receiving home healthcare services, access to telehealth virtual visits reduced likelihood of transfer to a higher level of care (such as a hospital or nursing home) to 15% as compared to 42% for those without telehealth monitoring
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A randomized trial showed patients with diabetes had better blood sugar control when they had access to telehealth services, and patients with hypertension experienced a significant decrease in systolic blood pressure as compared to those without telehealth services.
Extended availability

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Increase access to care by extending office hours into the early morning, evening, and weekend
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One study demonstrated significantly lower charges to patients due to the increased access offered in an after-hours clinic as compared to the emergency department. Median charges were $457 for children treated in the ED as compared to $140 for those with similar conditions treated the after hours clinic
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Another study demonstrated patients who had access to a primary care office with extended office hours had total healthcare expenditures that were significantly lower than patients that did not have access to these services
Walk in/Same Day Care

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Increase access to care by offering patient same day access to care and opportunities to walk in and receive care without an appointment
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Helps to eliminate unnecessary ER visits. It is estimated that over 9 million visits to the ER in the US each year are non-urgent.
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One study in Providence, RI showed an estimated $1.28 million cost from unnecessary ED visits was avoided by adding walk-in services to an existing free clinic