New West Texas clinic opens in rural health care desert

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On a current Thursday morning, John Hodges walked one in every of his older sufferers out the door. “God bless you for being here, John,” the affected person stated, shaking the nurse practitioner’s hand on his means out.

“It’s a security blanket,” stated Hodges, a local of Ralls. “I have elderly patients come in saying, ‘I can come here, I can’t go to Lubbock.’”

Ralls, about 30 miles east of Lubbock, sits in Crosby County and is on the sting of a West Texas medical desert, with restricted providers supplied at Crosbyton Clinic Hospital — the one hospital in the county. Other assets are additionally being stretched skinny attributable to close by counties that lack health care entry.

Even as Hodges tries to assist his group, he nonetheless faces the monetary uncertainty that plagues nearly all of rural clinics. His uncertainty is mirrored on the naked partitions of the Ralls Family Medicine clinic.

“We’re going to need to make it through these first three to six months,” Hodges defined.

The hurdles in Crosby County’s entry aren’t distinctive in the state. In the final decade, 20 rural hospitals closed in Texas, essentially the most in the nation. The closures are usually rooted in monetary hardship — sufferers could also be uninsured, there is probably not sufficient sufferers in a small city and Medicaid reimbursements are low. This has created a disaster for rural health care that was solely exasperated by the COVID-19 pandemic. According to the United Health Foundation, Texas is the least healthy state in the nation and has the best uninsured price at 18.4% in 2019.

“There are big swaths of West Texas, miles and miles without a lot of people,” stated John Henderson, CEO of the Texas Organization of Rural and Community Hospitals. “But the people who do live and work in those areas deserve access to care, just like the rest of the state.”

Hodges is attempting to bridge the gaps in rural health care. The small clinic serves the 1,740 Ralls residents and others in surrounding areas. About 20% of the city is older than 65.

Hodges labored at Crosbyton’s hospital till 2019, when administration announced adjustments coming to the clinic. Hodges discovered a job in Lubbock however felt responsible leaving his sufferers who didn’t have the assets to make the journey.

“When I left, I had a couple of patients who said, ‘What’s going to happen when you leave?’” Hodges recalled. “There’s two in particular that I remember, who are dead now. I still think, if I would have stayed in Crosbyton or if something was different, would they still be alive?”

The clinic was not Hodges’ authentic concept — Terry Hitt referred to as Hodges earlier this yr. Hitt, the brand new mayor of Ralls, stated Crosbyton’s hospital is barely there — there are solely two open beds for sufferers — so he needed a clinic in Ralls. And he needed Hodges, who handled so many individuals in the city earlier than, to guide it.

“It is something we needed here, instead of driving over to Lubbock,” Hitt stated. “We have a very large senior population, and I thought it would be really nice to have someone here in Ralls that they could come to.”

The clinic does have the help from metropolis management. The metropolis owns the constructing that homes the clinic and affords Hodges a “generous” price, and Hitt stated he and the town council will proceed to help the clinic and its doable enlargement.

“Every time I’ve been there, he is snowed under. There’s always a lot of people in there,” Hitt stated. “So if John needs something, he’s going to get it. We’re going to make sure of that.”

Hodges needed to make the clinic accessible and inexpensive. About 16% of Ralls residents live in poverty, and 20% of the county is uninsured.

“There’s a gap that everybody knows about, but nothing’s ever done, and it’s the gap of people that don’t qualify for Medicaid but can’t afford insurance,” Hodges stated. To stability it, Hodges affords fastened charges no matter insurance coverage — $35 workplace visits, $20 lab assessments, $15 COVID-19 assessments and free strep assessments.

It’s completely different from what Hodges is used to. He’s labored in places of work that cost considerably extra, however that value weighed on him.

“Knowing all day, there’s somebody that can barely pay their bills and I’m charging them $100 an office visit? I can’t do that,” stated Hodges.

So far, his charges have confirmed profitable. The clinic noticed 359 sufferers in its first month.

“Our price is right where we’re not breaking people to come in,” Hodges stated. “Patients can come in and get a whole set of annual labs for $100-$150, you don’t have to charge $1,000.”

Henderson stated that what Hodges is providing in Ralls is the type of care that might assist maintain sufferers out of hospitals.

“Wellness visits and chronic conditions are your bread and butter in rural Texas,” Henderson stated. “Playing offense instead of defense, trying to keep people from needing more care or hospitalizations, that approach is the center of primary care.”

Hodges stated he plans to begin taking insurance coverage as quickly as he will get approval to take action by medical regulators in the following few months. He’s optimistic however stated the clinic is in sink-or-swim mode financially for now. Hodges is attempting to have the clinic be a delegated rural health clinic, which might improve the reimbursement funds to the clinic for offering Medicaid and Medicare providers. Hodges stated there aren’t many avenues for funding by the state.

“People might wonder why other people don’t open up rural health clinics or clinics in general,” Hodges stated. “It’s very difficult.”

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