AURORA | Hospital bills in white envelopes kept piling up on Rebecca Yanes’s bookshelf last winter. Repeated visits to the emergency room between December and February led to thousands of dollars in medical bills. And there was the grief of having two toes amputated because of an infection.
For Yanes, the physical loss of her toes led to an emotional loss she couldn’t overcome. She thought she was going crazy when her toes started to hurt as if they were still there.
“I was really depressed,” said Yanes, who lives in north Aurora. “I couldn’t talk to my family or my husband. At that point I had given up.”
That was until she met Ari Hoffman, a psychotherapist with the Metro Community Provider Network’s Bridges to Care program. Noticing that Hoffman had missing fingers due to a birth defect, she decided to tell him about the phantom pain. Hoffman suggested that she pretend to call her toes on the phone and say goodbye to them.
“He’s crazier than me,” she thought. But she did it anyway.
“I said, ‘We’ve got to part company. After 54 years we’re not going to be together anymore. I’m going to get up and be able to take care of my family and myself.’”
Now, Yanes is in good spirits. The space where her toes used to be doesn’t hurt anymore. The Bridges to Care program also connected Yanes, who has diabetes, with a primary care doctor so she doesn’t need to continue visiting the ER and incurring costly medical bills.
If it weren’t for Hoffman and the Bridges to Care program, Yanes said she would have continued to emotionally suffer.
Bridges to Care launched in summer 2012 after the Metro Community Provider Network received a $4.4 million federal grant to help reduce patient visits to the emergency room in two low-income Aurora ZIP codes over the course of three years.
During the past year, MCPN has worked with the Aurora Mental Health Center, Aurora Health Access and Together Colorado to identify and help “hot-spotters” or people who frequently go to the ER for medical care.
A team of five health care professionals including nurses, mental health specialists and social workers work with each patient for 60 days to accurately diagnose their medical issues and help them decrease repeated ER visits. During the course of two months, the team visits each patient in his or her home eight times.
“A lot of the folks we’re working with were going to the ER a lot, and they aren’t using the ER for primary care anymore,” Hoffman said.
The program works well because each patient is seen by medical and mental health professionals, who talk to each other about each case and what the recommended course of action should be, Hoffman said.
“Not only are we at the forefront of trying to decrease ER and inpatient hospitalization but we’re also trying to integrate mental and physical health,” Hoffman said.
MCPN targeted two ZIP codes, 80010 and 80011, which include Aurora residents living in Original Aurora and right next to the University of Colorado Anschutz Medical Campus. About 80 percent of uninsured people living in those two ZIP codes have visited the emergency room for medical care because they are poor, don’t have health insurance, and don’t have a primary care doctor, according to MCPN. There are about 87,000 Aurora residents living in those two ZIP codes, both of which have a high number of people potentially without access to health care, according to MCPN officials.
“A lot of the things these individuals go to the hospital for are very avoidable,” said Heather Logan, director of MCPN’s Bridges to Care program.
For example, Aurora residents in those ZIP codes visit the ER for medication refills, fevers, aches and pains, allergies, flu-like symptoms and dental problems, Logan said. In Yanes’s case, she went to the ER because she had an unusual growth on her foot.
Those ER visits are expensive, and since many of the patients don’t have health insurance, the medical costs fall on taxpayers, Logan said. In one case, an uninsured Aurora patient in the Bridges to Care program had been to the ER six times within a six-month time frame, costing taxpayers $68,000, she said.
Since the program launched in July 2012, Bridges to Care has helped 70 patients. Next year, MCPN will work on refining and expanding the program and collecting data. The goal is to help 900 patients total by July 2015, saving $26 million in health care costs by stabilizing patients and decreasing their visits to the emergency room, said John Reid, vice president of fund development for MCPN.
MCPN has added 11 full-time employees to work for the Bridges to Care program using $1.2 million in federal funding over the past year.
Every medical professional who’s part of the Bridges to Care program takes a interest in helping patients get to the root of their medical issues, Reid said.
“They take on the attitude that each and every individual matters,” Reid said.
Sometimes the roles are reversed and patients end up making a big impact in the lives of Bridges to Care team members.
When Yanes told Hoffman about her phantom pains, psychotherapist Hoffman promised her that if she “called” her toes to say goodbye to them, that he would do the same with his fingers. When she went through with her end of the deal, Hoffman was hesitant to fulfill his part of the promise.
“Sometimes it’s easier to coach the game than to play it,” he said. One day, while driving in his car, he decided to dial up the missing fingers on his left hand and say goodbye to them. He cried. Both he and Yanes benefited from the closure.
“For stuff like this to work and be effective, you’ve got to make it like it’s real,” Hoffman said.
Reach reporter Sara Castellanos at 720-449-9036 or sara@aurorasentinel.com.