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2008 Summer Marillac Clinic Director's Corner

Marillac model of integrated care could be part of a larger solution to health care Steve Hurd, PhD., Executive Director


As Marillac celebrates its 20 years of service to Mesa County, we view it as a particularly appropriate time to look forward!

In 2000, the Clinic received a grant from the Robert Wood Johnson Foundation. That funding allowed the Clinic to pursue a model of health care that is known as Integrated Care.

Today, this model and Marillac's pioneering work is recognized nationally as an efficient and effective method for delivering health care. This model can be delivered to people with acute or chronic conditions. Integrated Care could very well be a key ingredient in the coming years to solving our national health care crisis.

Why is Integrated Care such a powerful model?

At Marillac, Integrated Care consists of five lines of service under one roof.  These include: Medical, Dental, Psychological, Optical, and Pharmaceutical. Together, they treat the whole person. Physical ailments frequently have psychological or lifestyle components that seriously impact treatment and successful outcomes. When medical care providers and mental health professionals collaborate to treat the whole patient, the likelihood of a successful outcome is dramatically increased.

By also adding dental and optical as well as a medication dispensary, Marillac becomes a true 'one-stop' medical home for our patients. That leads to greater efficiencies and demonstrable results that surpass the fragmented  approach to health care that currently exists.

Top-down solutions will miss the point.

So often, political solutions seem to favor top-down approaches. In this case, a top down approach will miss the benefits and requirements of a successful integrated care model. Part of what has made the Marillac model so successful is our practice of listening to what patients want and need. Here's what patients tell us and what we have proved will work:

Patients want one place to go for all their health care needs.

That argues for practices that blend disciplines – the opposite of current trends. Because of inequitable fee-for-service billing procedures, more medical students are choosing to specialize at the very time we need more Primary Care Practitioners. Fee- for-service reimbursement systems tie the hands of the provider who is only permitted to address symptoms instead of treating the whole patient.

Patients are willing and even proud to pay for their care,

but it has to be affordable. Marillac patients pay for their care on a sliding scale based on their ability to pay. When patients participate in paying for their health care, they're more apt to  be good collaborators and follow their doctor's instructions. Patients should know up front what their care and medicines will cost. We do that at Marillac every day. By reducing paperwork  and expensive back office collection operations, more resources are dedicated to patient care. There's no reason such a pay as you go system can't be part of a larger, nationwide solution.

Group appointments are efficient and effective.

Many conditions lend themselves to the positive dynamics of group appointments. Patients can benefit from sharing their challenges and successes with one another. When guided by a health care professional, group appointments become an important part of a successful treatment plan.

Twenty years of treating the families of Mesa County have helped Marillac Clinic develop highly effective and efficient strategies for delivering health care. Many of these systems and procedures are now recognized widely as "best practices". As we investigate health care reform both here in Colorado and nationwide, my hope is that we will find a way to make these proven medical homes become a  part of the bigger solution.

Please play a role in health care reform. Stay informed and speak out to your elected officials and friends. These reforms will require our best efforts and every voice should be heard.