• Skip to primary navigation
  • Skip to content
  • Skip to primary sidebar
  • Skip to footer

Center for Health Progress

  • Contact Us
  • Get Help
  • The People
    • Our Board
    • Our Staff
    • Our Members
    • Our Donors
  • The Issues
    • Coverage & Access
    • Health Equity
    • – Our Commitment
    • – Graphic Novel
    • Immigrant Health
    • Payment Reform
    • Social Determinants of Health
    • – Video
  • The Work
    • Policy Advocacy
    • – Bill Tracker
    • Community Partnerships
    • Community Organizing
    • Professional Services
  • The Impact
    • How Change Happens
    • Evaluating Success
  • Learn More
    • Blog
    • Our Publications
    • Our Events
    • – Annual Meeting
    • – HEALTHtalks
    • Our Values
    • Our History
    • Our New Name
  • Donate
You are here: Home / Learn More / Blog / Special Solutions to Specialty Care

Special Solutions to Specialty Care

Author: Joe Sammen
August 1, 2016 Filed Under: Access to Care, Coverage, Innovations, Providers & Workforce, Social Determinants of Health

wheelchair

Ten years ago this month, my mom was diagnosed with Stage 4 ovarian cancer. After the initial shock wore off, my family and I had to quickly come to terms with our new reality. My mom would require surgery to have her football-sized tumor removed, but she was lucky to be referred to an oncologist who specialized in female reproductive cancers.

We all loved her oncologist so much that when the referral was revoked for follow-up chemotherapy treatment, we were jolted. My parents were forced to change their insurance coverage so she could keep her oncologist. Despite these hurdles and an initial prognosis of only 18 months to live, my mom beat the odds and is as healthy as she’s ever been.

Many men and women with cancer aren’t as lucky as my mom and disparities in cancer morality and survivorship are well documented—especially among African Americans. One of the biggest contributors to this disparity is the increased rate of uninsurance and underinsurance among communities of color. If you don’t have quality, affordable health insurance, you’re going to struggle to find and pay for the services of an oncologist who will oversee and provide your cancer treatment.

Of course, cancer treatment is not the only specialty treatment that uninsured and underinsured patients struggle to find. Without insurance, many of these individuals are still able to receive high-quality primary care through safety nets or other charity care systems. However, as soon as they are diagnosed with a condition that requires a specialist, the safety net cannot always meet their needs. Due to low payment rates, high demand, and inability of patients to pay out-of-pocket medical costs (PDF), specialty providers in Colorado often won’t or can’t afford to treat uninsured patients or patients on Medicaid. More Americans are enrolled in health insurance than ever before, but this problem persists, especially for populations like immigrants without documentation who aren’t eligible for public health insurance programs or subsidies on health insurance exchanges, and people living in rural communities.

Local communities and health systems in Colorado have been attempting to address this specialty care gap for many years. Safety net clinics, like Doctors Care, connect uninsured patients to specialty care services. A number of Colorado’s health alliances are attempting to take a community-wide approach to increasing access to specialty care by building specialty care referral systems and e-consult programs. ECHO Colorado is building capacity for primary care providers to treat specialty care conditions in primary care settings by increasing their knowledge of specialty interventions. Given the systemic nature of this problem; however, we will need to continue to make large-scale changes to our payment systems and health insurance eligibility if we truly want to create solutions for everyone.

Around the same time as my mom was diagnosed, several other women with ovarian cancer were in the local headlines because they couldn’t get the specialty care treatment they needed. Each of these women couldn’t obtain quality health insurance for different reasons, including lack of citizenship status or inability to afford a health plan, and they ultimately shared the same tragic fate in the end: death. I thank the health care system every day for saving my mother’s life, but I won’t stop working until everyone is offered that same opportunity to thrive.

Related posts:

airplaneLong Distance coverageHealth Insurance Matters shadowpeopleFinding Room for Undocumented Immigrants in the Health Care System PrescriptionPrescribing Solutions

Blog Authors

Joe SammenJoe Sammen

Executive Director

Aubrey HillAubrey Hill

Director of Health Systems Change

Sarah McAfeeSarah McAfee

Director of Communications

Katie BayneKatie Bayne

Development & Communications Specialist

Jessica NguyenJessica Nguyen

Community Partnerships Specialist

Dana KennedyDana Kennedy

Director of Community Partnerships

Maggie GómezMaggie Gómez

Director of Community Organizing

Michelle MuñozMichelle Muñoz

Office Manager

Chris KleneChris Klene

Project Coordinator

Namuyaba TemanjuNamuyaba Temanju

Community Organizer

Joseph HawkinsJoseph Hawkins

Program Associate

Chris LyttleChris Lyttle

Public Policy Manager

Vicente Martinez OrtegaVicente Martinez Ortega

Community Organizer

Marcos ContrerasMarcos Contreras

Health & Research Associate

Recent Posts

  • Defending Our Civil Rights
  • The Benefits of Broadband
  • Acknowledging and Addressing Our Complicity
  • A Legacy of Unfair Immigration Policies
  • Prioritizing Non-Emergent Medical Transportation (NEMT)

Categories

  • Access to Care
  • Communications
  • Community Engagement
  • Community Partnerships
  • Coverage
  • Events
  • Health Equity
  • Healthy Living
  • Innovations
  • Leadership
  • Policy & Advocacy
  • Providers & Workforce
  • Social Determinants of Health
  • Systems Change

Blog Archives

Contact Us

Physical Address:
1245 E Colfax #202
Denver, Colorado 80218

Telephone:
720.583.1760

 

Mailing Address:
PO Box 18877
Denver, Colorado 80218

Email:
weare@centerforhealthprogress.org

GET CONNECTED

 

Join Our Listserv →

© 2018 · Center for Health Progress | Terms of Use

Developed By Firefly Partners