Jon Keagle had not been feeling all that spiffy for a while.
He was really tired, and sometimes he didn’t feel like eating and would go straight to bed after work.
Keagle figured he ought to see a doctor, but he didn’t have insurance, so he put it off.
Then one day, heading home from work with a friend, everything went black. If he opened his eyes, he got dizzy, so he stayed at the friend’s house for an hour before he could drive home.
Keagle has no insurance, no regular doctor and the kind of income that doesn't have room for a couple hundred dollars in doctor office bills and lab fees, but he got hooked up with a doctor through a new program run by the Lancaster County Medical Society that finds primary care doctors for people like him.
A few days after the almost-fainting incident, Keagle had an appointment at a local clinic and found out he had an H Pylori infection, which “eats a hole in your stomach.”
Keagle is an early participant in the Health 360 Primary Care program, funded with a $95,560 grant from the Community Health Endowment to help find medical care for the growing number of uninsured Lincoln residents.
People’s Health Center also received $106,561 to hire another doctor and set up weekend clinic hours using residents from the Lincoln Medical Education Partnership.
The two grants will help make primary care doctors available for more adults without health insurance while the People’s Health Center finds more space for expansion and the state and nation figure out how the new affordable health care program will work.
"We are hoping that the two grants will provide medical homes for another 1,400 people," said Lori Seibel, president of the endowment.
The ranks of uninsured adults in the county increased from about 9 percent in 2005 to about 19 percent in 2011. An estimated 34,000 adults age 18 to 64 have no health insurance.
Keagle actually took advantage of several available programs.
First, he went to the free Clinic with a Heart, which operates two nights a week and is run by volunteers. They took his blood pressure, asked him a lot of questions and said he needed additional evaluation.
So he went to the Health Hub at the Center for People in Need, where a staff member helps people manage the maze of medical resources, from applying for Medicaid and paying for medication to finding a doctor.
Keagle, 52, fit the criteria for the new program, so the Lancaster County Medical Society referred him to a cooperating local clinic.
Now, he's taking six pills a day, hoping to get better soon and get back to work driving a dump truck for a local construction company.
“I very much appreciate (the help)," he said. "I can’t afford thousands of dollars.”
The new program is aimed at people who are working because participants are expected to pay at least 40 percent of the cost of the care.
For an initial doctor’s visit, that’s about $40, said Joan Anderson, executive director for the Lancaster County Medical Society.
It’s better for the client and better for the doctors for people to have a medical home, to see the same doctor year after year, Anderson said.
This is a doctor who knows the patient’s history, has the lab reports and records so a patient doesn’t have to tell his or her story again and again.
And so he or she can have preventive care and not just see a doctor when sick, she said.
In fact, one of the target audiences is people with established medical homes who no longer have insurance.
It's been shown through research that medical homes provide the best outcomes, Seibel said.
Doctors who accept patients without health insurance are paid through the grant at Medicaid rates, Anderson said.
Lincoln’s medical home program may be unique. Anderson knows of no other community with a program like it.
It is modeled after a successful five-year-old specialty service program, where the Lancaster County Medical Society matches people without insurance with specialists, who provide surgery, or imaging or a cardiac evaluation.
Over the five years, specialty care has served 944 people, more than 50 a month, Anderson said. All local clinics have agreed to participate in the program or have a program of their own, she said.
Anderson is recruiting doctors for the new medical home program, expected to last 18 months and serve about 40 people a month.