Rochester General Hospital Refugee Healthcare Program: A Financially Sustainable Model

Three million refugees have come to this country since the enactment of the U.S. Refugee Act in 1980. Today, up to 5000 refugees arrive to New York annually; 90% of them resettle upstate. The volume of new patients has put unprecedented financial strains on local healthcare systems, and in much of upstate New York, providers have been forced to cease services to refugees or go into bankruptcy. In 2009, Rochester General Hospital (RGH) piloted a new model in the city of Rochester whose goal was to increase refugees' access to high quality primary care services in a cost effective and financially sustainable manner. The model's strategies include: developing strong partnerships with refugee resettlement agencies, providing the initial Refugee Health Assessments and capturing the associated funds, retaining Medicaid coverage after their initial six-month coverage period expires, recruiting new primary care practices, and coordinating services i.e. transportation, interpretation, and patient navigation. This resulted in $240,000 per year in additional income – half is used towards operational costs and half is paid to the physicians as an incentive to provide services to refugees. The RGH model has increased refugees' access to high quality and continuous primary care services. Approximately 1,953 refugees have been served by this program, and 96% of refugees entering Monroe County are in primary care practices. Using this model, none of the practices suffer financial strain. It is the only health program in New York State to have successfully achieved financial self-sustainability.