A health center in Harrisburg tries to keep up with demand, and braces for more
Ben Allen, General Assignment Reporter | 12.02.16
Photo by Ben Allen/WITF
Jeannine Peterson, CEO of Hamilton Health Center, says it's been rapidly expanding to meet demand for health services in the Harrisburg-area.
(Harrisburg) -- The Affordable Care Act has re-shaped health care in just a few short years.
On one hand, people who buy insurance through the exchange have faced higher and higher premiums.
On the other, more than 670,000 low-income Pennsylvanians have been able to get vital care through Medicaid through the ACA.
Of course, a lot of speculation is centered on what might happen to it as President-elect Donald Trump when moves into the White House.
But how the law is working now?
I took a trip to perhaps one of the busiest health clinics in the state, Hamilton Health Center.
Justin Berman has been a physician assistant at Hamilton Health Center for the past four-and-a-half years.
Working in Harrisburg's Allison Hill, he sees a lot of need.
The neighborhood has a median household income of about $30,000.
Photo by Lindsay Lazarski/WHYY
A blighted property on the 1100 block of Market Street near Cameron Street in Harrisburg, Pa.
Says Berman: "It's interesting. Every day is something a little bit different. From our bread and butter, diabetes, high blood pressure, back pain to there are people coming in, yesterday there was having a bullet lodged in their leg, and just needed to have it removed."
More than 30,000 people visit Hamilton every year.
It's a federally qualified health center - meaning it gets higher reimbursements for Medicaid patients, but like an emergency room - it legally can't turn anyone away.
Today, Berman's meeting with Charles Haverstock, a delivery driver for Kegel's Produce.
Haverstock is trying to resolve an issue with one of his prescriptions.
While Charles can afford the medication, Berman says others can't.
"8 dollars a month if you're taking 3 or 4 medicines, you're already talking 30 dollars a month extra when you're already pushing pennies. It's tricky."
Challenges every day
Many patients at Hamilton have Medicaid, but staff still has to get creative to make it work.
They give out samples that pharmaceutical companies provide, or search for discount programs.
The center has developed a strong reputation for its work, and patient visits increased by more than 12 percent from 2014 to 2015.
Another jump is expected this year, according to Hamilton CEO Jeannine Peterson.
"We are accepting new patients. In fact, we just hired 7 new medical providers so that we can keep up with this demand that we're seeing," says Peterson.
Medicaid expansion - part of the Affordable Care Act - is the largest driver of the increase.
The ACA has helped many low-income people proactively take care of themselves, instead of waiting until they got so sick they had to go to the emergency room.
But Peterson also says as more people pick high deductible health plans that require them to pay the full cost of care up to $3,000, $4,000 or sometimes even $5,000, they're turning to Hamilton.
She says: "We can make it more affordable for you. So it's not free, but it's not going to be the full cost of your deductible."
The word has spread to Cumberland County, and people have been making the trip across the Susquehanna River.
The expansive, gleaming building in Harrisburg is only a couple years old and bustling.
Peterson says that's a signal that there may be even more hidden demand for Hamilton's services.
She says her staff works to earn people's business.
"I think they're coming here because they understand it's safe. So while the perception is Harrisburg is a dangerous place to be, we're like a safety zone where people coming for care. Because if we weren't here, where would everybody go?" says Peterson.
Demand for services
Charles Haverstock is from Lancaster and drives in to Hamilton because he's always had a good experience.
But he also makes the trip because it's hard to find a doctor who will accept a new Medicaid patient.
He's anxious about his health.
Photo by Ben Allen/WITF
Justin Berman, one of the physician assistants at Hamilton Health Center in Harrisburg, says it's a challenging job, but one that is so rewarding.
Physician assistant Justin Berman worked in a similar role in private practice before coming to Hamilton.
He says the center is more challenging - he'll sometimes do two or three hours of studying after work to better understand a complicated case, because they can't afford to go to a specialist.
But people are also more willing to let him into their lives.
"Patients here are on a whole more grateful," says Berman.
"One got back from a colonoscopy after trying to convince him to go for the last 4 years. So he was one of my first patients. It's just little things like that."
All those little victories could disappear at some point in the future though, if the Affordable Care Act is repealed.
A state official says Medicaid coverage for 670,000 low-income Pennsylvanians would almost certainly end.
Preventative care and regular checkups?
As a result, Hamilton says demand for its services would probably increase even more, because people would have no place left to turn.