‘We have to earn trust’: How Akron General is closing the city’s health disparity gap

Dr. Sterling Shriber examines Roy A. Humphrey at Cleveland Clinic Akron General. A new program to address health disparities in Akron connected Humphrey with the primary-care physician and other support.
Dr. Sterling Shriber examines Roy A. Humphrey at Cleveland Clinic Akron General. A new program to address health disparities in Akron connected Humphrey with the primary-care physician and other support.
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Roy A. Humphrey was a basketball star at Akron's Central-Hower High School in 1978. He played in college and professionally overseas before returning home to Akron and working at Summit County Children’s Services for nearly 30 years before retiring in 2021.

But Humphrey, who remembers spinning a basketball on a stick to wow a young LeBron James in his front yard, said he “retired into poverty.” That caught up with him when he landed in the hospital in September with congestive heart failure, atrial fibrillation and acute kidney injury. He had no health insurance and was unable to pay for expensive medications.

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Humphrey, who lives in West Akron near Copley Road, didn’t know he had an underlying heart condition, which had sent him into heart failure, because he had never been to a primary-care doctor or received proper care, even when he had insurance through work.

"It was ignorance,” Humphrey said. “I was an athlete and, in my mind, I was a superhero and a professional athlete. I’m strong.”

A new program at Cleveland Clinic Akron General called ICARE, which is designed to help close health disparity gaps in the neighborhoods around the hospital, is helping Humphrey get back on his feet. He is being guided through what can be a complex medical system to help improve his health.

Humphrey told his new primary-care physician, Dr. Sterling Shriber, at a recent check-up that he was feeling fabulous.

“I feel like I was a 1932 Ford and you close the garage and open it up and I’m a Corvette ... but with a flat tire,” he joked since he still has an infection on his wrist that is clearing up.

What is the ICARE program?

The ICARE program, which stands for Integrating Clinical and Resource Evaluations, is funded through donations at Akron General. It is part of a larger campaign called Neighbor to Neighbor, which was launched in 2020 by Akron General President Brian Harte to specifically address health disparities in Summit County. So far, more than $2 million has been raised for the program, which includes efforts to address infant mortality and the Center for Family Medicine, which addresses health disparities and chronic diseases at its clinic.

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Harte, an internal medicine physician who provides care for hospitalized patients one week each month, developed the ICARE program after observing the patients from six ZIP codes near the hospital were readmitted at a disproportionately higher rate than other patients.  Those ZIP codes — 44302, 44307, 44308, 44311, 44314 and 44320 — cover a large area around the downtown Akron hospital and parts of Akron's Sherbondy Hill, Summit Lake, Kenmore and Highland Square neighborhoods.

“Our surrounding ZIP codes, despite their proximity to the hospital, have very poor health outcomes and very high socioeconomic needs,” he said.

Census data shows people living near the hospital have a life expectancy of 65 years, which is significantly lower than residents who live just west down Market Street closer to the Wallhaven area of Akron, where life expectancy is 81 years.

Dr. Brian Harte is Cleveland Clinic Akron General president.
Dr. Brian Harte is Cleveland Clinic Akron General president.

“We started by saying that perhaps we can make the biggest impact here and this is where we have to earn trust because these are our neighbors,” Harte said.

Hospitals have been under increased pressure in recent years to reduce readmissions.

Under the Affordable Care Act, the federal government can reduce hospitals' Medicare payments by as much as 3% per patient if they have high readmission rates. Those rates are based on unscheduled return hospital stays within 30 days for Medicare patients originally admitted for heart failure, heart attack, pneumonia, chronic lung disease, hip and knee replacement or coronary artery bypass graft surgery.

This year, Akron General has a readmission penalty of 0.39%, according to Kaiser Family Foundation's analysis of Centers for Medicare and Medicaid Services data. Summa Health System has a similar penalty of 0.41%.

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The goal of Akron General's new program is to have someone, and hopefully eventually a larger team, helping patients through the “complex fragmented health care ecosystem,” which often has gaps that people fall through and to close those gaps, Harte said.

Harte hopes Neighbor to Neighbor and programs such as ICARE can be a model for similar program at other Cleveland Clinic locations as well as other area health systems.  The hospital is not aware of other similar programs, but many hospitals are incorporating assessment questions around social determinants of health and health-related social needs.

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Connecting patients to resources

Julie Imani leads the ICARE program as a staff of one right now, but is connected to programs throughout the health system and the community to maximize help for participants.

Imani, a nurse for more than 30 years with a master’s degree in nursing and soon a master’s degree in public health, focuses on finding patients who meet the ICARE criteria in the hospital to assist. Because she’s still only a team of one, she can’t help all patients, but tries to focus on those who have been readmitted within 30 days. Sometimes, depending on her caseload, she will see an uninsured patient on a first admission to the hospital.

Julie Imani, a nurse with 30 years experience, leads the ICARE program at Cleveland Clinic Akron General. The program aims to close health disparities of patients who live near the hospital.
Julie Imani, a nurse with 30 years experience, leads the ICARE program at Cleveland Clinic Akron General. The program aims to close health disparities of patients who live near the hospital.

She connects patients with primary-care physicians and social service providers to address challenges like housing, food insecurity and transportation. She also follows up with patients once they are home to make sure they can access the resources they need.

“You can’t worry about getting to your doctor’s appointments if you are worried about food, shelter and other necessities,” Imani said. “We can be that bridge to provide a holistic approach.”

The program has $200,000 in philanthropic funding and at least a three-year minimum commitment. The hope is to expand the program with more staffers and beyond the initial neighborhoods around the hospital, Harte said.

In the first four months since the program started in February and Imani started seeing patients in May, she has helped 33 patients. She discovered 42% had food insecurity, 39% lacked transportation, 33% received shut-off notices for utilities, 27% reported housing insecurity, 39% needed help reading hospital materials and 33% reported loneliness.

From May through September, ICARE has decreased readmissions to the hospital by nearly 9% for patients who are discharged to a home in the ZIP codes around the hospital.

Imani said she has probably helped 45 patients so far. She usually averages working with patients about 30 days to get things straightened out, though some cases take longer.

Humphrey’s journey

Humphrey, now 62, was on the nationally ranked and No. 1 ranked team in the state in 1978 as a senior at Akron’s Central-Hower High School. His team lost the state championship to Archbishop Alter High School of Dayton and their star player, John Paxson, who would go on to play for the Chicago Bulls.

Roy A. Humphrey was named to the All-District team in Akron in 1978 as a senior at Central-Hower High School. Humphrey went on to play in college and professionally overseas for four years.
Roy A. Humphrey was named to the All-District team in Akron in 1978 as a senior at Central-Hower High School. Humphrey went on to play in college and professionally overseas for four years.

Humphrey then went on to play at West Virginia Wesleyan, graduating in 1982, before trying to make it in the NBA. He played overseas in Portugal, Brazil, Australia and China.

He returned to Akron in 1991 when his now late mother was getting sick with diabetes. Humphrey said he was just starting to make a name for himself, but needed to come home.

He worked for Summit County Children’s Service for nearly 30 years, first starting as a counselor and eventually worked in the family interaction center helping families and children to work on skills to get them back together.

How did Humphrey meet LeBron James?

Humphrey said he was friends with Gloria James, LeBron’s mom. He was visiting one day and when he walked outside, LeBron and his friend, Maverick Carter, were in the front yard.

Humphrey said his signature move to impress kids was to spin a basketball on his finger and then transfer the spinning ball to the kid’s finger, but LeBron’s fingers were too small. So Humphrey told the kids to get a stick and moved the ball to the stick.

“I said, ‘If you can control this, you can control the world.’ Humphrey said, joking that LeBron then grew up to take over Humphrey’s previous high school accolades.

Retiring into poverty

When Humphrey retired in 2021, the COVID-19 pandemic was still happening and he suddenly was relying on only his pension, which wasn’t enough to pay for private health insurance and everyday bills. Humphrey also made too much to qualify for Medicaid and at 62, is not yet eligible for Medicare coverage.

Dr. Sterling Shriber examines Roy A. Humphrey at Cleveland Clinic Akron General.
Dr. Sterling Shriber examines Roy A. Humphrey at Cleveland Clinic Akron General.

Humphrey said the money he made when he was playing professional basketball more than 30 years ago wasn’t like it is today.

In the year since his retirement, Humphrey said his gout, which he has had for decades but usually will go away, started bothering him more. He thought his gout was the reason he felt so terrible and had severe swelling from his feet up and abdominal pain when he had his daughter drive him to the emergency room Sept. 10.

He was transferred to Akron General, where he stayed in the hospital for seven days.

At the hospital, Imani met Humphrey. She saw that he did not have health insurance and lived in West Akron, one of the qualifying ZIP codes for the program.

Humphrey calls Imani his angel.

“She was like [legendary sports commentator] Howard Cosell or [legendary boxing promoter] Don King in your corner. She kept saying ‘It’s gonna be all right. She explained everything,” Humphrey said.

“I’m a big guy. I’m 6-foot-6, 250 pounds. But I was scared because that’s why I’ve never been to the hospital,” he said.

Humphrey qualified for hospital patient assistance, or charity care, for his hospital care and follow-up doctor’s visits due to his income, so Imani helped him set those things up.

Imani helped him apply for assistance through the pharmaceutical companies for some of his expensive heart medications, which cut down on cost. She also helped him with referrals for food through the hospital's food pantry and the local food bank and assistance for his utility bills.

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Workers are trying to guide him through the Affordable Care Act open enrollment period to see what subsidies he qualifies for to get insurance.

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Humphrey was discharged with medications and follow-up appointments.

But challenges with medications landed Humphrey back in the hospital within about 30 days — this time for congestive heart failure. He developed severe gout and an infection in his wrist, which required surgery. He spent nearly two weeks in the hospital for his second stay before being discharged.

Now, Humphrey said he feels great and he is very thankful for the care and financial assistance.

“It’s first-class treatment. They’ve treated me like I was a superstar coming home,” he said.

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Humphrey said many in the Black community, including him, don’t want to go to the doctor and can’t afford it, or try to wait things out.

“I kinda got humbled real quick,” Humphrey said of his recent medical needs.

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“This is my retirement. This is what I get. I get to take care of myself and make sure I don’t die.”

He also knows now that he needs to stay up on his medical care and medications.

“I feel great. They fixed me,” he said. “I’m a praying person. This is my second chance. I know He put me here for two things. I ain’t finished and he wants some more good work out of me.”

Beacon Journal staff reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ To see her most recent stories and columns, go to www.tinyurl.com/bettylinfisher 

This article originally appeared on Akron Beacon Journal: Cleveland Clinic Akron General program helps close racial health gap