Biological Sciences




free clinic; uninsured; Affordable Care Act; health disparities


Millions of Americans without insurance under the Affordable Care Act expansion fall into two categories: the ‘coverage gap’ and the ‘citizenship gap’. These two groups are disproportionately affected by health disparities due to low-income or legal status. Health disparities affect individuals in many aspects of their lives, including their health, finances, and overall quality of life. To improve the lives of uninsured individuals in Providence, Rhode Island Clínica Esperanza/Hope Clinic (CEHC) proposes to set up a Social Investment Bond Pay for Success program. CEHC has teamed with the Rhode Island Office of Health and Human Services and other RI organizations to coordinate this program, to be called, Bridging the Gap, which will enroll primarily Spanish speaking, low-income residents of Providence in continuity of care at the clinic and, in addition, nutrition education and lifestyle change programs. These patients will be followed as they transition to insured care, and the resulting reduction in the insured cost of care and health benefits (to the patients) will be measured and tracked. To prove that CEHC can successfully improve the health of our patients a feasibility assessment was performed (N=41) to show the improved results of chronic care management and access to healthcare. Based on a comprehensive chart review, this cohort of patients improved their health measures from baseline to endpoint (average follow up 0.5-5 years). The lowest level of improvement was a 37.5% decrease in total cholesterol in the hyperlipidemia patients. The highest level of improvement was an 88.9% improvement in HA1c