Department of
POLICY NOTES
Health Policy & Management
The University of Georgia  College of Public Health
HPAM Policy Brief Series 10 (1)
Free Health Care Clinics: Assessing the Economic
Benefits to Georgia Communities
By: Phaedra Corso, PhD & Angela Fertig, PhD
The use of emergency departments (ED) for
non-urgent medical treatment is well
documented (Baker & Baker, 1994; Grumbach,
Keane et al, 1993; Thompson & Glick, 1999). For
the uninsured and indigent, EDs may be the
only source of medical care available because
of federal laws prohibiting EDs from refusing
care based on ability to pay. However, the
economic impact of these wasted resources
can be enormous, placing a substantial drain
on hospitals and local communities which must
absorb the costs. In response to this, many
hospitals, communities, legislators, and nonprofit organizations are exploring different
avenues for providing primary care to the
uninsured. This brief presents new research
findings on the economic benefits associated
with free health care clinics targeted at the
uninsured in two Georgia communities:


Brunswick, GA: The Henri C. Woodman Free
Clinics in Brunswick and St. Mary’s provides
access to free primary care for community
members as part of the Coastal Medical
Access Project (CMAP).
Gainesville, GA: The Good News Clinics in
Gainesville offers free medical care to the
indigent, homeless, and low-income people
in Hall County, GA who have no health
insurance and cannot afford medical care.
In both communities, the costs associated with
non-urgent ED care decreased 14%-20% for a
sample of patients in the year after they enrolled
in the free health care clinic compared to the
year before enrollment in the clinic (See Figure 1).
This suggests that patients are going to the free
clinic instead of using costly ED resources in nonurgent situations. Moreover, costs related to inpatient care declined by 20% to 34% in both
communities. This evidence suggests that the free
clinics may halt the escalation of health problems
such that in-patient hospitalization use is reduced
or avoided all together.
In Brunswick, overall hospital costs also decreased
by 4%. While Gainesville did not see a decline in
overall hospital costs, a benefit-cost analysis
estimates that the Gainesville clinics will result in a
projected community savings of $185,000
annually – or approximately $893 per new clinic
enrollee in the one-year post clinic enrollment.
Figure 1. Decrease in Costs Pre and Post Clinic Enrollment
0%
-5%
-10%
-15%
-20%
Reducing Community Costs with Free
Health Care
-25%
The aim of this research is to estimate the
savings that result from having a free clinic in
the community in terms of reduced hospital
costs, with a particular focus on the costs of
non-urgent ED care.
-35%
hpam@uga.edu
-14%
-20%
Gainesville
-20%
Brunswick
-30%
-34%
-40%
Non-urgent ED
costs
285 South Jackson Street, Suite 100, Athens, GA 30602
Inpatient costs
706-542-6374
A caveat to these findings is that these analyses
also indicate an increase in both the costs of
urgent ED services as well as the costs of
“other” hospital services (like imaging services
and lab tests) post-clinic enrollment. This is due
to several factors, foremost among them being
that any free clinic population has poor, and
likely worsening, health conditions due to the
prior lack of consistent access to primary care.
Enrollment in the clinics likely leads to the
diagnosis of previously untreated conditions
that require the utilization of additional hospital
services. On the other hand, the savings to the
community is based on the lower cost of care
delivered at the clinic compared to the cost of
care in the ED. While this study only examines
cost savings one year after clinic enrollment, it is
likely that even greater savings would be
achieved over time as the long-term health
benefits of access to primary care are realized.
About the Authors
Phaedra S. Corso, PhD, MPA, is Associate Professor
and Head of the Department of Health Policy and
Management in the College of Public Health at the
University of Georgia (UGA). Prior to joining the UGA
faculty in 2006, Dr. Corso worked for 15 years at the
Centers for Disease Control and Prevention (CDC)
as an economic and policy analyst, most recently
in the area of injury and violence prevention. Her
research focuses on the practical application of
economic evaluation for setting public health
policy and assessing health-related quality of life in
vulnerable populations. Professor Corso received
her PhD in Health Policy from Harvard University,
and her MPA and BA from UGA.
Overall, these findings suggest that there is not
only a significant cost savings to both the
hospitals and communities that support free
clinics but that the health of this population of
patients is improved because of the existence
of the free clinics.
Angela Fertig, PhD, is an Assistant Professor in the
College of Public Health at the University of Georgia
in Athens, with a joint appointment in the Carl
Vinson Institute of Government. Professor Fertig’s
research focuses on issues related to low-income
families and maternal and child health. Prior to
joining the UGA faculty, she was an assistant
professor of economics at Indiana University in
Bloomington and a post-doctoral research fellow at
Princeton University. Professor Fertig received her
PhD in economics from Brown University and her MA
Acknowledgements
and BA from Stanford University.
We would like to acknowledge and thank our
funder for this project, the HealthCare Georgia
Foundation. Additionally, we are indebted to Cheryl
Christian at the Good News Clinics and Elissa
England at the Northeast Georgia Medical Center
for allowing us access to the data used for the
Gainesville sites. Further, we are grateful to Jeris
Wright and Pat Kota from the Coastal Medical
Access Project, and Shannon Webb from the
Southeast Georgia Health System for allowing us
access to the data used to evaluate the Brunswick
cites.
About the Department of Health Policy & Management
The mission of the Department of Health Policy and
Management (HPAM) is to advance the health of the
public through excellence in research, instruction, and
outreach by developing leadership and management
expertise and an evidence-based approach to policy
making. Health disparities are a universal thread in all
of these research areas, and the Department is
passionate about making progress towards reducing
existing inequalities in the public’s health.
Sources
Baker LC, Baker LS. (1994). Excess cost of emergency department visits for
nonurgent care. Health Affairs, 13, 162-167.
Grumbach K, Keane D, Bindman A. (1993). Primary care and public
emergency department overcrowding. American Journal of
Public Health, 83, 372-378.
Thompson KM, Glick DF. (1999). Cost analysis of emergency use by lowincome patients.” Nursing Economics. 17(3),142-8.
http://www.publichealth.uga.edu/HPAM