A collaborative way for low-income patients to maintain health and self-esteem

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[Originally published by FierceHealthcare]

Having once worked for a Medicaid HMO, I witnessed first-hand the impact that charity “free care” (in which individuals receive without having the opportunity to give back) had on an individual’s self-esteem, not to mention their health. This Medicaid program did well at supporting individuals through health crises, but lacked any real focus on improving the overall health status of an individual and a community. One key missing ingredient: supporting the patient’s self-esteem.

The Hygeia Foundation d/b/a True North Health Center in Falmouth, Maine, collaborated with a service exchange known as the Hour Exchange to offer an innovative, alternative monetary system where members trade services with one another. The Hour Exchange helps folks with limited financial means to “pay” for their care by providing services and performing tasks needed in the community.

In exchange, these folks received access to an innovative health care delivery system at True North, including cutting-edge chronic disease management, person-centered adult and pediatric care, integrated behavioral and physical health services and more. By giving people a way to “pay” for their care, the focus is on giving, receiving and maintaining one’s self-esteem and dignity.

Likewise, other organizations such as Franklin Memorial Hospital’s Contract for Care allowed people to volunteer and give back when they couldn’t otherwise pay for healthcare services. This empowers individuals to give something in exchange for what they receive, thus maintaining their self-esteem and dignity and improve engagement, adherence, and activation.

And it was also what so many of our patients requested. Their preference…

I don’t want hand outs. I want to contribute just like everyone else.

And in each of these cases, there was no need for government interventions. Rather it was a community of people coming together to innovate and care for one another.

In the True North example providers receive reimbursement for their time and effort (in the form of “time credits,” which they can “spend” on other services provided by Hour Exchange members) which continues the circle of both giving and receiving.

For it is in giving that we receive.

~ St. Francis of Assisi

Also in the case of True North, there are pilot studies that show people who access healthcare through this collaboration not only have access to care, but also significantly improve their overall health status … while also benefitting the community.

These are only two creative options that position individuals and communities for cost-effective and efficient healing by impacting one root cause to social challenges (low self-esteem). There are various other opportunities to focus on barriers to healing, and we all need to continue to be open, creative, innovative and engaged, in order to reach the goal of providing access and positioning people for optimal healing.


READ and LISTEN as npr highlights this True North access innovation:

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