Bridges to Care - Nashville's Answer to Health Care for the Uninsured

Like most communities, Nashville, Tennessee has a continuing problem of large numbers of uninsured persons who delay health care due to cost and then use high cost settings like hospital ERs when they must obtain care. Nashville addressed this problem through the development of two programs called Bridges to Care and Bridges to Care Plus. Both are the result of collaborative efforts by the city's public and private health care leadership beginning in the year 2000 which ultimately resulted in the formation of the Safety Net Consortium of Middle Tennessee, a not-for-profit corporation. The Consortium includes all “safety net” clinics in the city (including medical, dental, and behavioral health), the local medical society, and all ten medical-surgical hospitals. Bridges to Care links uninsured residents to a “medical home” where their charges are adjusted based on family size and income. Care Coordinators located at health department clinics and hospitals assist the uninsured choose the clinic that can best meet their needs based on geographic location, services, languages spoken, etc. Bridges to Care also provides transportation and prescription medications. 36,776 uninsured residents found a medical home through Bridges to Care in its first five years. The program also filled more than 152,325 prescriptions and provided more than 5,537 transports to medical services. Bridges to Care Plus provides access to specialty and hospital care for BTC enrollees with incomes less than 200% of poverty through a network of volunteer physicians and hospitals. This program has served more than 1,150 patients since March 2005.