Anti-Poverty Medicine Through Medical-Financial Partnerships: A New Approach to Child Poverty

Marcil, Lucy E.; Hole, Michael K.; Jackson, Jasmyne; Markowitz, Molly A.; Rosen, Laura; Sude, Leslie; Rosenthal, Alice; Bennett, Mary Beth; Sarkar, Sonia; Jones, N. M.; Topel, Kristin; Chamberlain, Lisa; Zuckerman, Barry; Kemper, Alex R.; Solomon, Barry S.; Bair-Merritt, Megan; Schickedanz, Adam; Vinci, Robert J.

doi:10.1016/j.acap.2021.03.017

Cited by 18 publications

(15 citation statements)

References 30 publications

(43 reference statements)

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“…However, this approach has limitations, including a lack of coordination between healthcare providers and community-based organizations, as well as access barriers (e.g., inadequate access to transportation, limited literacy, complex applications for benefits) that result in low follow-through rates on referrals (Crumley, Houston and Bank 2023). Strong evidence also shows that poverty affects biology, thus meriting direct treatment as a medical problem (Marcil et al 2021).…”

Section: Healing the Poormentioning

confidence: 99%

“…Antipoverty medicine is an emerging field addressing patients' financial strain via medical-financial partnerships (MFPs)-cross-sector collaborations in which health systems and financial services organizations align resources to improve health by reducing patients' financial strain. MFPs, which leverage the trust between patients and their healthcare providers, offer services in health settings that are tied to improved financial outcomes, including financial coaching, free tax preparation, budgeting, debt reduction, savings support, and job assistance (Marcil et al 2021).…”

Section: Healthcare's Role In Addressing Povertymentioning

confidence: 99%

“…Other MFPs focus on anticipating patients' hardships and reducing their expenses and liabilities. Examples include the Harbor-UCLA Medical-Financial Partnership, which offers medical bill arbitration and financial coaching that helps patients build cost-conscious budgets (Marcil et al 2021); "Dollar For," which has eliminated over $25 million of medical debt by helping people access Charity Care, an Affordable Care Act provision that reduces or eliminates medical bills for income-eligible individuals (Dollar For 2023); and Boston Medical Center's (BMC) community investment, which committed $6.5 million over 5 years, starting in 2017, to improving access to stable housing for its most vulnerable patients. This BMC effort aimed to reduce medical costs and address health issues tied to housing insecurity, such as asthma, lead exposure, and depression (McCluskey 2017).…”

Section: Healthcare's Role In Addressing Povertymentioning

confidence: 99%

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Reclaiming Healthcare’s Healing Mission for a Sustainable Future

Berry,

Yadav,

Hole

2023

Journal of Service Research

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Healthcare in the United States has reached a point where it is unsustainable for the long term, particularly for the poor, the elderly, and healthcare workers (HCWs) themselves. We propose a framework for making U.S. healthcare more sustainable, whereby the service returns to its core mission of healing. The framework casts that healing mission in broadly applicable, practical terms, whereby leaders of healthcare organizations and in the wider for-profit, not-for-profit, and governmental healthcare ecosystem take concrete steps to improve outcomes for patients and HCWs. Those steps involve aligning healthcare resources, incentives, and policies with the core mission of healing and then implementing change in specific ways that particular organizations have already shown are achievable and sustainable. We use those examples to illustrate how healing-oriented innovations in healthcare delivery get deployed and how progress toward sustainability then ensues. Lessons from these efforts can be tailored to individual healthcare contexts and institutions—and then applied on a national scale. The discussed initiatives can also guide the direction of future research on healthcare sustainability.

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Section: Healing the Poormentioning

confidence: 99%

Section: Healthcare's Role In Addressing Povertymentioning

confidence: 99%

Section: Healthcare's Role In Addressing Povertymentioning

confidence: 99%

See 1 more Smart Citation

Reclaiming Healthcare’s Healing Mission for a Sustainable Future

Berry,

Yadav,

Hole

2023

Journal of Service Research

Self Cite

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“…The two most prominent services are financial coaching and tax preparation services (Dalembert et al, 2021;Marcil et al, 2021).…”

Section: How the Intervention Might Workmentioning

confidence: 99%

PROTOCOL: Medical‐financial partnerships for improving financial and health outcomes for lower‐income Americans: A systematic review

Birkenmaier,

Maynard,

Shanks

et al. 2023

Campbell Systematic Reviews

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This is the protocol for a Campbell systematic review. The primary objectives of this review is to answer the following research questions using formal research studies: What is the extent and quality of MFP intervention research? What are the effects on financial outcomes of financial services embedded within healthcare settings? What are the effects on health‐related outcomes of financial services embedded within healthcare settings?

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“…13 However, it remains unknown why low-income families underutilize VITA and other free financial services or what would motivate them to consistently engage with such services. [14][15][16][17] Hence, as pediatrics begins to embed financial services in clinic and community settings, 18 qualitative research is needed to understand factors necessary for financial service acceptability and use to improve uptake and effectiveness, with the long-term goal of mitigating racial and socioeconomic inequities in child health and development. To this point, it is critical to include families of color in this research who may identify unique factors.…”

mentioning

confidence: 99%

Embedding Financial Services in Frequented, Trusted Settings: Building on Families' Pre-existing Economic Mobility Efforts

Alexander

Kim

Hatcher

et al. 2022

J Dev Behav Pediatr

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The aim of this study was to understand parents'/guardians' experiences and aspirations around economic mobility and their impact on the acceptability and use of financial services embedded in frequented, trusted settings such as schools and pediatric clinics. Method: We recruited 18 English-speaking guardians with at least 1 child enrolled in a school for low-income families and eligible for Internal Revenue Service-sponsored free tax preparation. Each participant completed a semistructured interview before tax filing; a subset completed follow-up interviews. We used grounded theory analysis. Results: We developed the following theoretical model based on our key thematic findings to describe the acceptability and use of financial services within the context of guardians' lived experiences and pre-existing efforts to build economic mobility: Families experience multilevel barriers to economic mobility. Despite these barriers, guardians are proactively working to build economic mobility by empowering the next generation with knowledge, skills, and assets and resiliently pursuing economic goals. As a result, guardians will accept empowering, nonjudgmental, expert, and trustworthy financial services that contribute to their existing efforts. To move from acceptance to use, financial services must be effectively publicized, accessible, and supportive. Conclusion: Financial services may be more acceptable and used if they are embedded in trusted organizations and have expert, supportive staff with lived experience who empower guardians to work toward their economic goals, accessible platforms, and effective publicity. These characteristics may facilitate uptake and economic mobility. Trusted organizations serving young families can partner with financial services to test these findings and help families build economic mobility.

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Anti-Poverty Medicine Through Medical-Financial Partnerships: A New Approach to Child Poverty

Cited by 18 publications

References 30 publications

Reclaiming Healthcare’s Healing Mission for a Sustainable Future

Reclaiming Healthcare’s Healing Mission for a Sustainable Future

PROTOCOL: Medical‐financial partnerships for improving financial and health outcomes for lower‐income Americans: A systematic review

Embedding Financial Services in Frequented, Trusted Settings: Building on Families' Pre-existing Economic Mobility Efforts

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