P2143 - Increasing Access to Colonoscopies for Under-Resourced Patients at Good Neighbor Health Clinic: Success of a Free Community Clinic and Academic Medical Center Partnership

Award: Presidential Poster Award

Timothy McAuliffe, BA¹, Adriana Radosavljevic, BS¹, Michelle D.. Dong, BSc, MSc¹, Rachael Chacko, BA¹, Lauren Barry, BA², Elizabeth R. Austin, ³, Corey A.. Siegel, MD, MS⁴, Timothy B.. Gardner, MD, MS^2
1Geisel School of Medicine, Hanover, NH; ²Dartmouth Hitchcock Medical Center, Lebanon, NH; ³Good Neighbor Health Clinic, Enfield, NH; ⁴Dartmouth-Hitchcock Medical Center, Lebanon, NH

Introduction: Despite the importance of colonoscopies in evaluating gastrointestinal symptoms, the high cost is prohibitive for many under-resourced patients. Free community clinics, such as the Good Neighbor Health Clinic (GNHC) in New Hampshire and Vermont, play an important role in the care of these patients. We describe a partnership between a free community clinic and a tertiary academic medical center to provide free diagnostic colonoscopies for symptomatic under-resourced patients.

Methods: After analyzing GNHC and Vermont state data, we discovered an unmet need for diagnostic colonoscopies that could be addressed with external funding to improve care quality (Figure 1). With this objective, our team connected with the clinical and operational leadership within the Dartmouth-Hitchcock (DH) Section of Gastroenterology and Hepatology to inaugurate a program that would support diagnostic colonoscopies for these patients.

Results: After developing a proposal and conducting meetings with DH Gastroenterology and Finance leadership, GNHC was granted funding support for ten diagnostic colonoscopies per year by DH at no cost to under-resourced patients. We delineated the clinical guidelines for colonoscopy access to include GNHC patients with positive FIT screening, hematochezia, and inflammatory bowel disease management. We organized a standardized protocol that GNHC could use to refer patients for this program, efficiently connecting patients with DH Gastroenterology and a timely colonoscopy. Working with DH Finance leadership, a system and specific billing codes were finalized to provide a diagnostic colonoscopy to patients. Support for this program is provided by three DH gastroenterologists conducting colonoscopies and providing appropriate follow-up through GNHC. Since the program’s initiation in October 2023, three patients have successfully obtained colonoscopies through this charity care funding model at no cost.

Discussion: Through this project, we identified a need for diagnostic colonoscopy funding among under-resourced patients, collaborated with partners at GNHC and DH to secure financial coverage, and developed a logistical and financial system to provide these essential procedures. This program has successfully provided colonoscopies for GNHC patients at no cost and can serve as a model for other community clinics to expand care for under-resourced patients.



Disclosures:


Timothy McAuliffe, BA¹, Adriana Radosavljevic, BS¹, Michelle D.. Dong, BSc, MSc¹, Rachael Chacko, BA¹, Lauren Barry, BA², Elizabeth R. Austin, ³, Corey A.. Siegel, MD, MS⁴, Timothy B.. Gardner, MD, MS². P2143 - Increasing Access to Colonoscopies for Under-Resourced Patients at Good Neighbor Health Clinic: Success of a Free Community Clinic and Academic Medical Center Partnership, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.