Wednesday, July 9, 2014

Physicians may help move people from poverty

By Chris Berry, MD, DCMS CARES medical director; and Billy Lane, DCMS director of community service

This article originally appeared in the June issue of the Dallas Medical Journal. The Dallas County Medical Society Cares program (DCMS CARES) helps physicians deliver quality care to their uninsured or underinsured patients by providing access to affordable prescription medications at more than 600 retail pharmacies in the Dallas/Fort Worth area. 

In July, DCMS CARES will surpass the $10,000 mark. This means the program will have paid more than $10,000 in pharmacy expenses for uninsured and underinsured patients of DCMS physicians. In the “big picture,” $10,000 is not a tremendous amount of money, especially for a program that helps people with essentials such as food, housing or, in this case, medication. However, even fractions of this amount can stabilize a financially stressed household budget.

Dallas internist Roger Khetan, MD, participates in DCMS CARES because the program “gives me an alternative to help my patients who have significant financial distress and who cannot afford their medications.”

He has enrolled one patient in DCMS CARES.

“It was a true live-saver for her,” he says. “She was without a job, had no disabilityincome, had lost her home, and had moved in with her son. DCMS CARES helped her get medications for her seizures and diabetes, which had just gotten better controlled, and has helped her while she is awaiting disability benefits to kick in.”

According the United Way Community Financial Stability Initiative, a key factor for a family to move out of poverty permanently is the ability to leverage public benefits as a bridge to a well-paying job. “Public benefits” refers to major programs such as SNAP (Supplemental Nutrition Assistance Program), WIC (Women, Infants and Children), CHIP (Children’s Health Insurance Program), and TANF (Temporary Aid to Needy Families). Yet, smaller, privately funded benefits such as DCMS CARES easily could join this list.

Consider this monthly budget representing a household of two — a working parent and his or her child. Imagine that the adult makes $10.10 per hour (the minimum wage in Texas is $7.25) and works a 40-hour week. The parent’s total monthly gross income is $1,750; see the table below for expenses.

Estimated Monthly Expenses
Rent, one-bedroom apartment $550
Child care $400
Utilities $90
Cell phone $80
Vehicle $200
Vehicle insurance $65
Fuel $200
Basic groceries $300
Infant's groceries $140
Internet $60
Total $2085

Obviously, the bottom line on this budget exceeds the gross monthly income of $1,750 (before taxes). Suppose that you are the patient’s physician, and you treat the patient at no charge. You determine that the patient’s asthma is best controlled using a medication that retails for about $250 for a 30-day supply. Your assistant prepares a pharmaceutical manufacturer’s prescription assistance application on behalf of the patient, and the application requires at least 60 days to process. During this time, your participation in DCMS CARES can provide the patient with a point of leverage so that the other critical line items in the budget remain fairly stable. Your patient can go to any retail pharmacy in the Dallas area, pay a maximum copay of $20, and get the medication needed to control his or her asthma. By taking fewer sick days at work, the patient can continue on the path to a well-paying job.

Donations to the Dallas County Medical Society Foundation and a grant from the Texas Medical Association Foundation enable DCMS CARES to pay the bulk of the cost for this medication. As of July, this scenario will have played out to the tune of $10,000. More than a dollar amount, the money becomes an important factor toward financial stability for dozens of patients.

“Physicians who use the program are very good stewards of the fund and sign up patients who really need assistance,” Dr. Khetan says.

“The process of enrolling my patient was very easy and well-supported by DCMS administration,” Dr. Khetan continues. “Response time is quick, and support of the program comes from people you trust — fellow DCMS physicians.”

DCMS physicians: For details on how to participate in DCMS CARES, contact Billy Lane at billy@dallas-cms.org or 214-413-1433.

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