In a changing health care environment, St. Thomas Community Health Center has emerged to provide comprehensive primary care for individuals with or without insurance by implementing sustainable practices.

Whether school physicals, flu shots, routine care or illness, St. Thomas clinics provides care at Donald T. Erwin Center, 1936 Magazine St.; St. Thomas Community Health Center, 1020 St. Andrew St.; and Columbia Parc Health Center, 3943 St. Bernard Ave. Optometry only is offered at St. Thomas at Mahalia Jackson, 2405 Jackson Ave.

St. Thomas clinics have reached people with and without insurance in the Irish Channel since 1987. Homeless patients, for example, pay nothing; those earning less than 200 percent of the federal poverty level pay fees on a sliding scale.

And while clinic staff are helping people meet their health care needs, they also help them meet their health care goals. Appointments are available with certified enrollment specialists to offer assistance registering for insurance coverage under the Affordable Care Act. The ACA deadline for coverage is Feb. 15.

Not long ago, however, the clinics were in danger of closing, according to St. Thomas Chief Executive Officer Dr. Donald Erwin. It was a turning point last year when Gov. Bobby Jindal refused to expand Medicaid as a component of the ACA.

Federally qualified health centers like St. Thomas Community Health Center suddenly faced a fiscal crisis. Uninsured patients at St. Thomas rose from 18 percent to more than 35 percent as a result of a change in Medicaid eligibility requirements.

“With reduced funds provided to safety net clinics through the Greater New Orleans Health Connection, we had to come up with ways to be more efficient and cost-effective,” Erwin said. “Our business model and the number of people we were seeing would not sustain us.”

Confronted by a serious financial shortfall, Erwin was referred to the Institute of Healthcare Optimization in Boston, an independent nonprofit that had helped several hospitals find ways to reduce costs while improving the quality of care.

Erwin said he told IHO, “Unless you give us some help, we may not be in business.”

The firm agreed to discount its fees, providing a seven-month consultation that greatly improved efficiencies in appointment-setting and patient visits with the clinic’s six physicians and six nurse practitioners. IHO provided a comprehensive plan to achieve “systems optimization.”

“It was transformational for us,” Erwin said.

IHO’s collaborative team, including project managers, senior vice presidents and a data analyst, visited New Orleans in April.

“They are in such an underserved area and to meet the demands, there was a lot to handle without jeopardizing the quality. We wanted to do everything we could to help,” said Meng Kang, IHO’s director of program development.

As a result, St. Thomas Clinic has experienced a 35 percent increase in appointment capacity and a 25 percent increase in patient visits. Increased efficiency has created additional time slots for same-day appointments.

“Efficiencies like these are what clinics like us need to achieve,” Erwin said.

Whereas an urgent care center might charge $200 for a walk-in, the average bill for a same-day office visit for low-income patients without insurance is $30.

“IHO health care research says most people want to see somebody today rather than their family doctor. We’ll take our chances that you might like us enough to stay,” Erwin said.

St. Thomas Community Health Clinic offers same-day appointments for walk-in patients. Services include pediatric, adult primary care, women’s health, behavioral counseling, allergy testing, optometry and eye exams, chronic disease management, infectious disease, obstetrics and mammography.

For information, call (504) 529-5558 or visit www.st thomaschc.org.