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Annals of Family Medicine 4:S22-S27 (2006)
© 2006 Annals of Family Medicine, Inc.
doi: 10.1370/afm.539

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The Health Commons and Care of New Mexico’s Uninsured

Arthur Kaufman, MD1, Daniel Derksen, MD1, Charles Alfero, BA2, Robert DeFelice, MBA, MPH3, Saverio Sava, MD1,2, Angelo Tomedi, MD1, Nicola Baptiste, BA4, Leora Jaeger4 and Wayne Powell, BA1

1 Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, NM
2 First Choice Community Healthcare, Inc, Albuquerque, NM
3 Hidalgo Medical Services, Lordsburg, NM
4 Sandoval County Community Health Alliance, Bernalillo, NM

CORRESPONDING AUTHOR: Daniel Derksen, MD, Department of Family and Community Medicine, MSC 09 5040, 1 University of New Mexico, Albuquerque, NM 87131-0001, DDerksen{at}salud.unm.edu

PURPOSE A seamless system of social, behavioral, and medical services for the uninsured was created to address the social determinants of disease, reduce health disparities, and foster local economic development in 2 inner-city neighborhoods and 2 rural counties in New Mexico.

METHODS Our family medicine department helped urban and rural communities that had large uninsured, minority populations create Health Commons models. These models of care are characterized by health planning shared by community stakeholders; 1-stop shopping for medical, behavioral, and social services; employment of community health workers bridging the clinic and the community; and job creation.

RESULTS Outcomes of the Health Commons included creation of a Web-based assignment of uninsured emergency department patients to primary care homes, reducing return visits by 31%; creation of a Web-based interface allowing partner organizations with incompatible information systems to share medical information; and creation of a statewide telephone Health Advice Line offering rural and urban uninsured individuals access to health and social service information and referrals 24 hours a day, 7 days a week. The Health Commons created jobs and has been sustained by attracting local investment and external public and private funding for its products. Our department’s role in developing the Health Commons helped the academic health center (AHC) form mutually beneficial community partnerships with surrounding and distant urban and rural communities.

CONCLUSIONS Broad stakeholder participation built trust and investment in the Health Commons, expanding services for the uninsured. This participation also fostered marketable innovations applicable to all Health Commons’ sites. Family medicine can promote the Health Commons as a venue for linking complementary strengths of the AHC and the community, while addressing the unique needs of each. Overall, our experience suggests that family medicine can play a leadership role in building collaborative approaches to seemingly intractable health problems among the uninsured, benefiting not only the community, but also the AHC.

Key Words: Health Commons • community health care • family medicine • academic health centers • collaboration • uninsured • poverty • medically underserved area • primary care




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TRACK Comments:

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Kaufman et al. The Health Commons
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Annals of Family Medicine, 26 Sep 2006 [Full text]
A Model for Us All
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