How providers are battling bad health ratings in Southeast Missouri

Despite the variety of health care providers in Cape Girardeau, many of its neighbors are greatly underserved, according to a recent study. Nine of the 10 least healthy counties in Missouri were found to be in Southeast Missouri, reported the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. The study compiled data from each county related to clinical care, social and economic care, physical environment and health behaviors to determine the rankings. Local medical providers say they're already working to provide affordable care for patients throughout the region.

"There is a tremendous need out there for regular preventive care and screenings to identify health problems and address them before they become something else," says Lesley O'Daniel, a registered nurse with the SHOW Mobile, or SoutheastHEALTH on Wheels. The service, a partnership between SoutheastHEALTH and Southeast Missouri State University, travels to Oran and Charleston, Mo., to provide basic care and screenings to those in need, and further south for flu clinics and health awareness events.

"Our intention is not to compete with local providers, but to fill the gaps," says O'Daniel. "Access really is the point of the service. A lot of people we find who use our service don't have transportation, or if they have a vehicle, they aren't able to afford the gas for it. A lot of our patients walk to us."

Many rely on the SHOW Mobile as a primary care provider and for regular care of chronic conditions like diabetes, she says.

"We would like to go more places. The idea is to go further south where the providers are more spread out," says O'Daniel. However, the SHOW Mobile's nurse practitioner must work within a 50-mile radius of the collaborating physician, according to Missouri state law, and O'Daniel says they don't have the funds -- yet -- to travel with a physician.

"We are looking at some options to expand into the southernmost areas using some telemedicine technology," she adds. With telemedicine, patients would be able to meet with doctors via real-time video conferencing, allowing a means for consultation without travel.

Meanwhile, Saint Francis Medical Center has partnered with several outlying providers to offer primary and specialty care. According to Steven Bjelich, president and CEO of the hospital, Saint Francis addresses unmet health and wellness needs during its strategic planning process, and has long worked to meet those needs.

"We seek ways to improve medical center services beyond the campus to serve the region and make health care more affordable and accessible," he says, adding that primary and specialty care access have been priorities. "Many of the counties in Saint Francis Medical Center's rural and tertiary service areas have experienced critical shortages of medical specialties," he says.

The hospital partners with Missouri Delta Medical Center in Sikeston, Mo., for cancer services; Perry County Memorial Hospital in Perryville, Mo., for wound care; Farmington Medical Practices in Farmington, Mo., for gastrointestinal care; and Parkland Health Center, also in Farmington, for neurology and neurosurgery. Saint Francis and Poplar Bluff Medical Partners together developed a campus in Poplar Bluff, Mo., to offer diagnostic imaging, outpatient surgery and a clinical setting. Saint Francis also provides a number of health education programs and free or discounted health screenings.

Cross Trails Medical Center has locations in Cape Girardeau, Marble Hill and Advance, Mo., but sees patients from as far as Wayne County and the Bootheel, says Chrissy Warren, chief operating officer at Cross Trails. Like Southeast and Saint Francis, Cross Trails has identified a demand for affordable primary care. Most in need, she says, are chronic disease management and mental health services.

"With the current state of the economy, and financial stress, health is not always a priority when people are faced with paying the bills and taking care of their families," says Leigh Hampton, a family nurse practitioner at Cross Trails in Cape Girardeau. "There is a large population without health insurance, Medicare or Medicaid."

Says Warren, "That's why Cross Trails exists -- to help those people without the financial means take care of their health care needs."

To do this, Cross Trails accepts Medicare and Medicaid; offers a sliding fee scale based on income guidelines; and participates in the Show Me Healthy Women and Vaccines for Children programs. The clinic has a case manager who works with patients on transportation and personal needs and refers them to other helpful community services. The Cape Girardeau office serves as the main site for telemedicine, especially useful for dermatology and psychiatry, say Warren and Hampton.

"We will see any patient, regardless of their ability to pay," says Hampton. "It's not a free clinic, but we're willing to reach out and try to help to the fullest extent we can and offer affordable health care."