Community Impact Report Mosaic Medical | 2019 -2020

Advocating for our patients

Along with the rest of the world, Mosaic was challenged to adapt like never before this last year. What I find remarkable is that—despite the unprecedented circumstances—our people just kept on doing what they always do: providing high quality healthcare to those who need it most.

As you’ll read in the small sampling of patient stories that follow, Mosaic kept helping people find a way to afford their medications. Mosaic kept fighting to help children get the care they deserve. And through our comprehensive medical, dental and other services, Mosaic kept walking alongside patients on their paths of recovery and healing.

Also in this unprecedented year, we remained constant in our commitment to expand our services to more people. We opened our first retail pharmacy in Prineville, completed a buildout on a new community-funded mobile clinic and made progress on plans for new clinic locations.

We are energized by our work and excited for the future. Thank you for helping us honor another year of service.

Year in Review

Demand for Mosaic Medical services continued to grow during the last fiscal year (July 2019 - June 2020). Below, we provide a summary of our patient demographics, service offerings and financials for the year.

Patient Stories - Paula and Courtney

Fostering fresh starts

By the time Paula moved to Central Oregon in 2017, she had accomplished a lot. She had quit drinking. She had quit taking opioids originally prescribed after a serious fall at work. And, she had built up the courage to address health issues she had put off for years.

“I knew I needed to get help for stuff that had come up since I got sober,” said Paula. “I just had to figure out where to start.”

Paula found a listing for Mosaic Medical during a search for local health services. She established with a primary care provider who also helped her connect with staff in Mosaic’s newly opened dental suite.

“It had been 13 years since I had seen a dentist,” said Paula. “I was embarrassed and fearful to go in, but I knew my mouth health needed some serious work.”

Over the years, Paula had developed periodontal disease. Her workplace accident had also damaged her front teeth. She needed extractions, scaling and root planing as well as support developing new hygiene habits to restore her oral health.

“My dental hygienist, Courtney, was so kind and welcoming from the moment I walked in,” said Paula. “She helped me sort out my dental coverage and taught me how to take care of my teeth after I finished treatments.”

Working with a team she could trust, Paula became a model dental patient. She kept up with her cleanings and diligently followed Courtney’s hygiene recommendations.

“It was so wonderful to see her take such pride in her health,” said Courtney. “She created a fresh start for herself and she wasn’t taking it for granted.”

Paula’s newfound oral health brought other benefits, too. Her blood pressure went down and other health metrics improved. She was so impressed with the results that she convinced her husband—who was also wary of medical professionals—to give Mosaic Medical a try.

“I’m so thankful for Mosaic and their employees,” said Paula. “You just feel true caring when you walk through the door. It’s beyond anything I’ve experienced.”

Paula with Mosaic dental hygienist, Courtney.

Elmer and Alison

Making medication affordable

While he had faced high prescription copays in the past, Elmer had never seen anything like this and the stakes had never been higher.

Elmer receives his primary care at Mosaic, and was referred to an oncologist after an abnormal colonoscopy. He was diagnosed with colon cancer and prescribed a chemotherapy medication to slow the spread of the disease.

“It is such a rollercoaster to be prescribed a critical medication, and then find out later that it costs as much as a mortgage payment,” said Elmer. “I don’t know anyone who could afford to pay that much on medication every month.”

This wasn’t the first time that Elmer was forced to choose between buying medication or forgoing treatment to make other ends meet. As he has in the past, he turned to Mosaic Pharmacy for support.

“I knew about the Mosaic Pharmacy because they helped me find a way to pay for my maintenance inhalers,” he said. “I was at my breaking point with the inhalers when I met the Mosaic Pharmacy Team.”

Due to the 340B savings that the Mosaic Pharmacy receives as a Federally Qualified Health Center, the organization is able to buy medications at a significantly reduced rate, and pass savings along to their clients.

“The 340B program was made for patients like Elmer,” said pharmacist Alison Hoffman. “It is unreasonable to expect patients with limited incomes to pay for medications that are billed in the triple digits.”

Working together, the Mosaic Pharmacy team was able to get Elmer enrolled in a sliding scale program that matched his income. When paired with the savings associated with the 340B program, his out of pocket costs for both his inhalers and chemotherapy medication dipped to a level that he could comfortably afford every month.

“The Mosaic Pharmacy gave me a chance to fight for my health,” said Elmer. “It puts people on a level playing field, and I am so grateful.”

Elmer with Mosaic pharmacist Alison Hoffman.

The Mosaic Pharmacy - Prineville opened to both patients and the general public in March. The organization plans to open additional pharmacy locations in Bend and Madras to serve more Central Oregonians.

Brad, Beau and Sonia

Getting patients on their feet

Like most adolescent boys, Brad loves being outside, playing soccer and jumping on his trampoline. Unfortunately, unlike his peers, Brad was born with congenital claw toe, an anomaly in his feet that caused him significant pain with any sort of activity.

“After he played, he couldn’t fall asleep because of pain,” said Brad’s mother. “And the next morning, he’d wake up in pain.”

Over the years, Brad had tried everything to get better. He taped his toes down so they’d be straight. He did stretching exercises with physical therapy. He wore larger shoes, tighter shoes, shoes with orthotic inserts and even no shoes at all. Nothing he tried seemed to work.

There was one solution—orthopedic surgery—but Brad’s condition was not covered under his insurance. The family had already submitted two appeals, but both were denied. By the time they turned to Mosaic Medical, Brad’s future was uncertain and the family was losing hope.

Determined to help, a Mosaic Community Health Worker named Sonia joined Brad’s care team led by Mosaic Pediatrician Dr. Beau Gilmore.

Together, Sonia and Brad’s mother mounted a third appeal, but it too was denied. Undeterred, Sonia helped the family lobby for an in-person hearing. When the appeals agency lost Brad’s paperwork, Sonia made a copy and helped the family resubmit.

Meanwhile, Brad’s situation worsened. He experienced significant abdominal pain due to a side effect from the medicine meant to relieve his foot pain. His mood was deteriorating at home, too. He often asked “why me?” through tears of frustration.

And then, finally, a decision on Brad’s fourth appeal arrived. He was approved, and received surgery earlier this summer right before his birthday. Since that time, he has been more active with friends than ever. His mood improved, his energy returned, and he’s even helping around the house more often.

Brad (far right) with his mother, Isaurah, and brothers.
Brad with Community Health Worker, Sonia.
Brad with Pediatrician Dr. Beau Gilmore.

Mosaic’s team-based approach to care opens new doors for patients. In addition to Community Health Workers, our Nurse Case Managers and Enrollment Specialists help break down barriers related to insurance and help families access basic needs.

Adapting to a new normal

In a surprising way, the stress of the pandemic helped highlight some of Mosaic’s unique strengths. It showed how agile we can be in launching new resources like the behavioral health and OHP enrollment hotlines. It highlighted the deep trust we’ve established with the Spanish-speaking community. And it reinforced the critical role we fill in Central Oregon. The experience has galvanized us to keep innovating and keep working to strengthen patient safety nets both now and in the future.

Ensuring quality care

Mosaic Medical is governed by a volunteer, patient-majority board of directors with representatives from Crook, Deschutes and Jefferson Counties. We are grateful for our board members who share their time and talent with us to ensure that everyone has access to quality care throughout Central Oregon.

2019-2020 Board of Directors

Patient Advisory Councils

Over 50 patients sit on our Patient Advisory Councils and provide a valuable perspective related to the delivery of care and communication across Mosaic’s 15 clinics. We are extremely appreciative of their donated time and knowledge.

Prineville patient advisors touring the Pharmacy space on Jan. 23.

Collaborating for Change

Thank you to our community partners and supporters, who help advance our mission by collaborating with us in regional health initiatives and by providing in-kind and/or financial support:

Special thanks to Ely Roberts for capturing patient and staff portraits for this report.