Focusing on core issues that precipitate medical problems, Palmetto Health in Columbia, S.C., has demonstrated success in expanding access to services and eliminating drastic disparities.
Its impressive array of accomplishments includes programs to delay or avert the onset of type 2 diabetes, community partnerships to serve uninsured and underinsured patients, and efforts to promote sexual abstinence among teenagers while providing prenatal care to help young moms deliver healthier babies.
In recognition of such broad-based initiatives aimed at the most vulnerable citizens within socioeconomically and racially diverse neighborhoods, Palmetto Health has won the 2014 Foster G. McGaw Prize for Excellence in Community Service. The winner receives $100,000.
Each year since 1986, a health care organization has received the award for fostering innovative programs that greatly improve the health and well-being of its community. The award is sponsored by the Baxter International Foundation, the American Hospital Association and the Health Research & Educational Trust.
“As a safety net health care system, Palmetto Health strives to create and implement initiatives that reduce health disparities,” says John O’Brien, chair of the Foster G. McGaw Prize Committee. “The system’s outstanding community benefit programs target the root causes of poor health — whether physical, mental or emotional.”
Efforts to make a difference are far-reaching. “Palmetto Health provides much-needed care to the underserved, encourages residents to take charge of their health, and addresses the mental and emotional well-being of its community,” O’Brien adds. “To succeed with these programs, Palmetto Health leaders work in partnership with many other organizations, and together form the foundation of a strong and sustainable community commitment.”
As the largest and most comprehensive integrated health care system in South Carolina’s Midlands region, Palmetto Health treats nearly a half million patients each year. It was established in 1998 with the merger of two major hospital systems. From 1998 to 2014, the organization funded $42 million in community service programs, allocating 10 percent of its bottom line every year to providing care for indigent, uninsured and underserved populations.
The organization’s leaders constantly contemplate, “How can we best utilize our resources to touch people who might fall through the cracks?” says Charles D. Beaman Jr., CEO of Palmetto Health, which was named a Foster McGaw finalist in 2010 and 2011. Palmetto Health’s stated vision is: “To be remembered by each patient as providing the care and compassion we want for our families and ourselves.”
“South Carolina is a poor and rural state, and we have a number of citizens who fall below the federal income poverty guidelines,” says Vince Ford, chief community health services officer. A changing payer mix, coupled with state leaders’ rejection of Medicaid expansion, has intensified the financial challenges. “In spite of that, Palmetto Health has stepped up and has been providing services to that population free of charge as part of our charity care program,” he says. These efforts underscore “a core commitment of Palmetto Health from the very beginning.”
South Carolina ranks seventh among states having the highest percentage of adults with diabetes. Through its Changing Lifestyles program, Palmetto Health recruits prediabetic individuals to help them postpone or avert type 2 diabetes with supervised exercise, nutrition classes and counseling.
During the past three years, 64 percent of adult participants demonstrated measurable improvements in body mass index, weight, blood pressure, waist circumference and the HbA1c blood test, which is used to determine how well a person is managing diabetes.
In 2014, a team of registered nurses and case managers identified 1,760 out of 4,060 HbA1c screenings as abnormal. Of those, 1,068 were classified as prediabetic and 29 were diagnosed as diabetic, says Tiffany Sullivan, director of community outreach programs.
Greater awareness of diabetes has come from sending “ambassador teams” to lead strategy sessions in communities — in churches, on job sites and anywhere else people are able to complete a risk assessment. “We listen to our constituents,” Sullivan explains. “We know that our tactics won’t work if their voices aren’t included.”
Among the participants was Rhonda Marshall, 54, a full-time librarian. In November 2013, a free HbA1c screening served as a wake-up call when it detected prediabetes. Marshall, who hadn’t been exercising, felt tired after work. She also hadn’t paid much attention to her food choices. Armed with this new information, she resolved to modify her lifestyle. She now goes to a gym several times per week and keeps a nutrition journal.
After being diagnosed with lupus as a teenager and undergoing a kidney transplant about 11 years ago, Marshall knew she was at elevated risk for diabetes. Despite check-ups every three months, she says none of her physicians ever recommended measuring HbA1c — a more sensitive indicator for diabetes than a standard glucose test.
“If it hadn’t been for that screening at Palmetto Health, I would have developed diabetes,” says Marshall, who now volunteers to help others lower their risks. “I really am happy to be an ambassador for Palmetto Health because they spare no expense or staff as far as trying to get the information out to the public.”
Another program, Better Together, recognizes the benefits of community partnerships. In 2013, Palmetto Health collaborated with other local organizations to provide more than $13 million in services, ranging from bereavement and grief support to car seat safety checks, breastfeeding classes, asthma education, speaking engagements, cancer support groups, pharmacy, swim clinics, scholarships and school partnerships.
A program called Healthy Choices operates under the premise that unplanned teenage pregnancy affects not only the mother and baby, but also the community’s overall health. Under the program’s umbrella of services, the weekly Teen Talk development program guides middle and high school students in making better decisions, while Palmetto Healthy Start offers education and support to young moms.
“We believe in a comprehensive approach to teen pregnancy,” says Stacey McPhail, director of the maternal and child health initiative and community partner programs. That approach has shown significant success. In 2013, among students enrolled in Teen Talk, there were no reported pregnancies. Meanwhile, the rate of infant mortality was 1.2 per 1,000 live births for Palmetto Healthy Start participants, compared with 8.4 per live births for nonparticipants in 2013.
Palmetto Health leaders say their efforts are focused on the whole individual. Programs that fill gaps in mental and emotional health, as well as dental care and vision services, address unmet needs for residents living below 200 percent of the federal poverty guidelines. The system delivered $173 million in charity care in 2013. This included free breast and cervical exams and colorectal and prostate cancer screenings, as well as appropriate follow-up care.
Something to smile about
Heather Roberts, 44, had been dealing with deteriorating teeth and tooth pain for years — until Palmetto Health stepped in to help. After undergoing 23 extractions between November 2014 and January at no cost to her, Roberts expects to received the dental treatment she needs.
“It has made my life a lot easier,” Roberts says. “My teeth were literally crumbling. They couldn’t be saved unless I had root canals or implants.” Without dental insurance, “it’s a tough thing to go through.”
To alleviate pain and suffering, Palmetto Health partnered with local dentists who agreed to accept fixed rates. Patients also have the option of continuing to visit the same dentist after their immediate pain is resolved.
“All of a sudden, patients who would have gone to an emergency room for pain now have a dental network available to them,” says CEO Beaman. “You can replicate that scenario across a number of different programs.”
Extending outreach remains at the heart of the community service endeavors. Its vision initiative in schools, for instance, provides free screenings and prescription eyeglasses. This made it possible for a student who had experienced great difficulty academically to do much better. Once a significant sight disorder was corrected with glasses, Beaman says, “It was like a whole new life for this child.” — Susan Kreimer is a freelance medical writer in New York City.
2014 Foster McGaw Prize Finalists
These three finalists also were recognized for their significant accomplishments in community service. Each received a $10,000 prize:
Spectrum Health in Grand Rapids, Mich., for its efforts to improve the health of the communities it serves through a healthy food partnership aimed at needy individuals, a healthy lifestyle program and a school health advocacy program.
Children’s Hospital of Philadelphia for its ability to work in partnership with families and community groups to promote health and wellness among vulnerable children in the area.
White Memorial Medical Center in Los Angeles, for its emphasis on providing quality care for the whole person — mind, body and spirit — with the goal of extending health and wellness to its community.