In October, the Centers for Medicare and Medicaid Services officially added outreach sites and roads. the list The “Occupational Claims Place of Service Code” already includes sites such as homeless shelters, schools, offices, private residences, and mobile units.
This update is welcome news for Penn Medicine Lancaster General Health's street medicine program, said Dr. Jeffrey Martin, director of the Department of Family and Community Medicine.
The program is run by rotating medical residents and relies primarily on health system funding, grants and private donations. With plans to soon expand and hire full-time staff, Martin hoped the new reimbursement would help in those efforts.
“There will be more visitors,” he said. “We look forward to further collaboration with other health systems and the ability to serve more people.”
But Martin said that in order to actually bill for services and receive reimbursement, providers must enroll patients in insurance programs like Medicaid, which can be a potential barrier. said.
“The first goal is to build relationships and let them know, 'This is a group of people who come out on a regular basis and we care about your health care,'” he said. “At some point, once trust is better established, they may feel more comfortable providing their information to enroll in Medicaid.”
There are also restrictions on which providers can charge fees for their services. Pennsylvania lists physicians, certified nurse midwives, advanced practice clinicians, psychologists, and other professionals as eligible, but does not specifically include certified nurses.
Julie Dees said she hopes that will eventually change. She is the CEO of the Bucks County Family Services Association. street medical program A certified nurse and social worker are always on site.
“We're doing the same work and getting the same results as hospitals with doctors,” Dees said. I'm excited because it's a step in the right direction, but there's a lot of work to do to improve. ”
“On the front line”
Back in Philadelphia's Kensington neighborhood, Kara Cohen and Sam Santiago continue driving around, looking for familiar faces among their patients.
On the way, I passed a young woman lying against a building, her face swollen and her complexion turning gray.
“Are you okay?” Santiago yelled from the car window. She signaled that the woman might need an ambulance.
When the car stopped, Cohen said, “Please let me get out.”
Cohen immediately checked the woman's breathing and heart rate, then called an ambulance, which arrived about 15 minutes later and transported the woman to a nearby hospital.
Mr. Cohen suspected that the woman had a heart problem, possibly suffering from heart failure. She texted a friend of hers who works in the emergency room of a hospital near her to let her know about the new patient, hoping to get an update later.
“It's really heartbreaking to see people just trying to survive,” Cohen said. “Sometimes we feel like we're on the front lines of a war, in combat. When we get home, it's hard to get that out of our heads and when we think about all our families. It’s really hard.”
New service provisions and insurance reimbursements should help ease some of the burden, at least financially, she said.
When it comes to emotional and psychological burdens, Cohen said, small individuals get help. They remind her that there is still an opportunity for street medicine to grow and help even more people.
