An Analysis of the Community Impact of Charity Medical Clinics in North Texas

Abstract The cost of medical services continues to be a major barrier to healthcare accessibility for many individuals in America. Community charity medical clinics help address this disparity by providing free or reduced-cost care for the medically underinsured; however, their economic and public health contributions have yet to be well analyzed. This cross-sectional study was conducted to investigate the services provided in four primary-care charity clinics in North Texas. Only encounters completed within the study period by a physician or physician assistant with sufficient documentation to assign a level of service were reviewed for this study. Centers for Medicare and Medicaid Services Evaluation and Management Standards were used to identify the level of service provided for each encounter, and their subsequent value was determined based on Centers for Medicare and Medicaid Services fee-for-service schedules at the time service was provided. Common conditions managed during these encounters were identified using ICD-10 codes documented with each encounter. 3942 encounters were identified, and 2148 (54.5%) were audited. The most prevalent diagnoses encountered were hypertension, diabetes, hyperlipidemia, and major depressive disorder. We estimate the total value of services and medications provided for one year is between $840,278.30 to $845,737.41. Findings indicated that community, charity clinics provide a significant economic impact through a high level of care and a broad scope of services for a vulnerable patient population. The results of this study may be used in the development and implementation of future services to meet the needs of the medically underinsured.