The Press of Atlantic City

ATLANTIC CITY, N.J. (AP) _ At this summer picnic, free hot dogs and hamburgers for the guests can lead to free blood-pressure checks and diabetes screenings _ which can actually save dollars and cents for the sponsors.

That’s one of the main ideas behind the Homeless Picnic hosted for the past nine years _ and again Friday _ by AtlantiCare at its Mission HealthCare facility in Atlantic City.

AtlantiCare officials are happy with how their Homeless Picnic has grown, from 80 or so guests in its first year to 500-plus this year _ enough people to make the cooks run out of some of the more popular menu items.

But they’re also happy with the bottom-line results of an ongoing effort to reduce the number of people who use AtlantiCare’s emergency rooms as their doctor’s office of choice _ because those patients think they have no other access to health care, so they wait until they’re desperate and then go to the ER.

Getting patients into primary-care facilities instead, including Mission HealthCare’s two locations, one of them right at the Atlantic City Rescue Mission, “saves dollars and improves health care access, quality and cost,” said Sandy Festa, administrative director of the AtlantiCare HealthPlex, which also is the Atlantic Avenue home of the other branch of Mission HealthCare.

Festa, who has been part of most of these picnics, told The Press of Atlantic City ( that the factors that keep homeless people out of most primary-care medical offices include a lack of health insurance and the lack of a doctor who understands their needs. Those special needs for homeless patients can include social services, mental health counseling and often substance-abuse problems.

“Regular doctors’ offices don’t know the path to get out of homelessness,” Festa said Friday, as guests _ and T-shirt-wearing staffers for AtlantiCare, the Rescue Mission and other social-service agencies _ strolled by.

Keith Smith lives in Somers Point now, but for almost 10 years, he spent his nights in the Rescue Mission, he said after his lunch Friday.

He has gone to the emergency room for care in the past, but he credits AtlantiCare for helping him get “substance-abuse and alcohol treatment,” and he has been sober now for seven years, he said.

The Rescue Mission helped him find health insurance, and he’s still getting psychological counseling and other services.

“All the outreach kind of reached me,” he said.

Steven Blumberg, an AtlantiCare senior vice president, said an emergency-department visit costs four to five times as much as a visit to a “lower-acuity” office, such as Mission HealthCare.

And those patients who wait to go to the ER aren’t just expensive to treat, they’re also not in the right place to have their own needs met. They may have to wait for hours if other patients come in with more serious conditions that do require emergency treatment.

“Uninsured, insured, Medicaid _ we’ll see everyone. But when they show up in the (emergency room) for low-acuity care, that’s not the most appropriate setting, but we must care for them, because they’ve presented,” he said.

“So we’ve worked hard to get folks redirected” to more appropriate locations, he said, and for many patients, “the best way to intervene is to intercept them before … in the decision-making process.”

And outreach efforts, including the picnic for homeless guests, appear to be showing progress. Mission HealthCare saw 3,600 patients last year for about 20,000 visits, Blumberg said _ by people who may have otherwise gone to the emergency room.

AtlantiCare provided $30.8 million in charity care services last year, according to the hospital’s figures, and got reimbursed by the state for about $24.7 million. And that’s a big improvement for the hospital from past years, mostly because of Medicaid expansion, a spokeswoman said. In 2013, AtlantiCare provided about $56 million worth of charity care but was reimbursed for just $24.8 million.