Monica Barczak, PhD, Director, Indigent Healthcare Funding, Ascension St. John
Established in 1926, Ascension St. John (ASJ) is a fully integrated healthcare delivery system encompassing six hospitals and more than 90 clinics and facilities in eastern Oklahoma and southeastern Kansas.
At the core of the health system’s mission is a commitment to serving all persons, with special attention to those who are poor and vulnerable. ASJ provides a broad range of inpatient and outpatient services and is nationally and regionally recognized for its services.
As a major healthcare provider, one Tulsa Equality Indicator in the public health theme that is of interest to ASJ is health insurance by race. The measure itself does not show tremendous disparity. However, the report notes that this is because “Tulsans in general, regardless of race, are relatively equally uninsured.” For the past two years, ASJ has been part of a broad community coalition working for Medicaid expansion, to allow more low-income people to qualify for Medicaid (SoonerCare) benefits. On July 1, 2021, Oklahoma will join the 37 other states already implementing Medicaid expansion. As a result, more Tulsans will be able to manage their health through primary, preventive and other routine care, reducing the risk of a health crisis and Emergency Department visit.
An Equality Indicator showing an unacceptable level of disparity is infant mortality by race. ASJ has several initiatives aimed at improving infant and maternal health, and collects data to look for disparities in outcomes. ASJ has participated in the Oklahoma Perinatal Quality Improvement Collaborative (OPQIC) since its inception in 2014. OPQIC provides leadership and engages Oklahoma birthing hospitals to improve health outcomes for Oklahoma women and infants using evidence-based practice guidelines and quality improvement processes.
Specific areas of focus include identifying and addressing unconscious bias in healthcare; increasing meaningful communication among patients, nurses, and providers; standardizing coordination of care and response to emergencies; and continually improving the delivery of quality prenatal and postpartum care, with an emphasis on promoting early prenatal care in physicians’ offices and routine postpartum checks within six weeks after delivery. As a result, ASJ is seeing improving trends in both the ‘Severe Maternal Morbidity Rate’ and ‘Prenatal and Postpartum Visits’ for Black women.
ASJ looks outside its hospital and clinical walls as well. For example, the Medical Access Program (MAP) awards grants to a number of clinics that provide free primary care to low-income uninsured patients. MAP further pays for eligible patients at these clinics (as well as other sliding-fee scale clinics) to receive diagnostic and specialty services at ASJ. Another example is ASJ’s Community Benefit program, which offers small grants to community-based organizations addressing public health issues such as food security, mental health and well-being, healthy behaviors, and adverse childhood experiences.