Marshfield Clinic has another program that helps patients make the best use of all resources. The Clinic's Patient Assistance Center coordinates the Community Care Program, which provides free or low-cost care to indigent patients. In 1999, Marshfield Clinic provided more than $7 million in free care through Community Care.

Marshfield Clinic promised to serve all patients since its creation in 1916. Serving patients based on need -- not ability to pay -- is part of the Clinic's mission and also is a requirement of the Clinic's not-for-profit status. The cost of Community Care has grown significantly over the past several years, most likely due to the growth of the Marshfield Clinic system, said Michael T. Wood, M.D., chairman of the Community Care Committee at Marshfield Clinic. But it's nothing new, he said.

About half of Marshfield Clinic's providers are outside of Marshfield, so it stands to reason that about half the Community Care is outside Marshfield as well, Dr. Wood said. "It depends on the community and what people need," he said. "People in more affluent communities use less Community Care. People in other communities use more." In 1999, about $1 million in Community Care was given to people within the Marshfield zip code. In previous years, the charity care was given on a less formal basis. Physicians provided prescription samples and downgraded office visits to help their patients afford medical care. By making the program more formal, it reaches more patients and allows providers to take care of patients while other people help with payment concerns.

The Patient Assistance Center helps coordinate all areas of patient need, from Community Care to Family Health Center to private sources for help. Whether it's making payment arrangements, arranging a ride home or finding a place to stay, Patient Assistance Center staff are available to help.

"It's really whatever needs to be done," said Pat Beining, assistant manager of the Patient Assistance Center. Although the main department is housed within the Marshfield Center, other Marshfield Clinic centers have staff available to help patients as well, Beining continued.

"If people have lost a job, or they have unexpected expenses, or they just need some help, we try to find a way to help," said Stacey Ruggles, assistant director of Patient Financial Services. There are established criteria to assess whether patients qualify for Community Care, also called charity care, she continued.

"We look at whether there are other programs available, such as the Veteran's Administration hospitals, private groups, Healthy Start or Family Health Center," she said. Sometimes a combination of programs can be used to help patients.

Family Health Center and Community Care are just two programs in place for Marshfield Clinic to reach people in need of medical care.

"The Clinic's mission is to serve patients," Dr. Wood said. "Those physicians who have chosen to come here to practice are here, to a large extent, because of the Clinic's philosophy." Community Care is a reflection of the mission rather than a separate program. It has been formalized so patients who need help can be helped and to encourage others to make use of the Clinic, he added. "It really is a procedure to identify all needy patients in our system to make sure they understand that we are going to care for them."