LeRoi Hicks, M.D., MPH, MACP

President, ChristianaCare, Wilmington campus ChristianaCare

  • Newark DE

Dr. Hicks is the recipient of numerous clinical and research awards and is nationally known for his research on health care disparities.

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2 min

Wilmington Campus Receives $1 Million Donation From the Rocco A. and Mary Abessinio Foundation

ChristianaCare has received a $1 million gift from The Rocco A. and Mary Abessinio Foundation Inc. in support of ChristianaCare’s Wilmington Campus. “All families and communities deserve the excellent care that Wilmington Hospital and ChristianaCare provide,” said Rocco and Mary Abessinio. “It is an honor for our family to support the health and wellbeing of the Wilmington community.” The funds will support areas of greatest need, including the expansion of patient care initiatives aimed at reducing disparities in screening and treatment for cancer and cardiovascular disease in the city of Wilmington. “We are tremendously grateful to the Rocco A. and Mary Abessinio Foundation for their continued, generous support of the Wilmington Campus – a vital resource serving the greater Wilmington community,” said Janice Nevin, M.D., MPH, ChristianaCare president and CEO. “With their help, we are closing gaps in health disparities and improving health for everyone, including some of Delaware’s most vulnerable populations.” The Rocco A. and Mary Abessinio Foundation provided a $1 million gift in 2014 for the redesign and renovation of the health center, which was then named the Rocco A. Abessinio Family Health Center at Wilmington Hospital. The health center is home to three primary care practices and other programs and services that offer high-quality health care, wellness and preventive health visits for people of all ages, regardless of their income or ability to pay. “As a result of the Abessinio family’s longstanding partnership and investment in our mission of service, we are making significant progress in addressing disparities and building strong and healthy communities,” said LeRoi S. Hicks, M.D., MPH, FACP, campus executive director of ChristianaCare’s Wilmington Hospital. A Wilmington landmark in the heart of the city, the ChristianaCare Wilmington Hospital has been serving the diverse medical needs of the city and surrounding region for over 125 years. “Philanthropy is essential to ChristianaCare’s mission of service to our community, and we extend our heartfelt thanks and appreciation to Rocco and Mary Abessinio for their inspiring and visionary philanthropic leadership in support of the Wilmington Campus,” said Dia Williams Adams, MPA, vice president of philanthropy at ChristianaCare. “Their gift is a legacy that not only allows us to increase our ability to make a positive impact on patients and community, but honors the incredible work that our caregivers do every day.” For more information about ways to support ChristianaCare’s mission of service to the community, visit: https://christianacare.org/us/en/make-a-gift.

LeRoi Hicks, M.D., MPH, MACP

5 min

This Is a Critical Moment: Delaware Must Not Go Backward in Health Equity

The proposed Delaware House Bill 350 is well-intended but would have terrible consequences for Delaware’s most vulnerable populations. There is a better way. By LeRoi S. Hicks, M.D., MPH, FACP As a Black physician who has dedicated his 25-year career to understanding and addressing health equity, I am deeply concerned about Delaware’s proposed House Bill 350, which aims to address rising health care costs by establishing a body of political appointees that would oversee the budgets of Delaware’s nonprofit hospitals. While the goal of bending the cost curve in health care may be well-intentioned, this bill will have horrific consequences for Delaware’s most vulnerable populations, including Black people, Hispanic people and other groups that have been traditionally underserved in health care. We can and must work together to solve this problem and provide the right care, in the right place, at the right time. A tale of two cities To borrow a phrase from Charles Dickens, Delaware, like much of America, is a tale of two cities. The experience of life—including a healthy, safe environment and access to good-quality health care—is vastly different depending on where you live and your demographic background. In the city of Wilmington, for example, ZIP codes that are just a few miles apart represent more than 20 years difference in life expectancy. This is not OK—it’s a sign that we have serious structural problems in our communities that are causing harm to people and making their lives shorter. Importantly, chopping $360 million out of Delaware’s hospital budgets, as House Bill 350 would do in year one, is not going to help this problem—it’s going to make it worse. And in doing so, it would ultimately make health care in Delaware more expensive—not less expensive. The key to lowering health care costs is to improve quality, access and equity Data show that about 5% of patients in the United States account for more than 50% of all health care costs. These are primarily patients who have complex and poorly managed chronic conditions that cause them to end up in the most expensive care settings—hospitals, operating rooms, emergency departments. The key to driving down health care costs is to improve quality and equity so that everyone is supported in achieving their best health, and these high users of the most expensive kinds of care are better supported in managing their health conditions such as diabetes or heart failure in the appropriate way. In doing so, they prevent the need for costly emergency or “rescue” care. Let’s do more—not less—of what we already know works Health care is not a one-size-fits-all industry. The delivery of care for patients across a diverse population requires multiple interventions at the same time. These interventions are designed not only to improve the quality of care but also to close the gap in terms of health care disparities. That’s important, because when we improve care and outcomes for the most vulnerable populations, we tend to get things right for everyone. One type of intervention is about doing exactly the right things for a patient based on the evidence of what will help—and doing nothing extra that will cause harm or generate additional costs without providing additional benefit. An example of this might be ensuring that every patient who has a heart attack gets a certain drug called a beta blocker right after their heart attack, and they receive clear guidance and support on the actions they must take to reduce their risk of a second heart attack, such as regular exercise and good nutrition. The second type of intervention is for the highest-risk populations. These are patients who live in poor communities where there are no gyms and no grocery stores, and people commonly have challenges with transportation and lack of access to resources that makes it difficult—sometimes impossible—to follow their plan for follow-up care. They lack access to high-nutrient food that reduces their risk of a second heart attack. They also live in areas where there are fewer health care providers compared to more affluent areas. These interventions tend to be very intensive and do not generate income for health systems; in fact, they require significant non-reimbursed investment, but they are necessary to keep our most vulnerable patients healthy. The medical community has developed interventions for these populations that are proven to work. A local example is the Delaware Food Pharmacy program, which connects at-risk patients with healthy food and supports their ability to prepare it. The program helps patients improve their overall health and effectively manage their chronic conditions so they can prevent an adverse event that would put them back in the hospital or emergency department. When we work together, we succeed We’ve seen incredible examples of how this work can be successful right here in Delaware. Delaware was the first state in the country to eliminate a racial disparity in colorectal cancer, and we did this by expanding cancer services, including making it easy for vulnerable people to get preventive cancer care and screenings. This is an incredible success story that continues to this day, and it was the result of thoughtful, detail-oriented partnerships among the state and the health care community. The work continues as we collaborate to reduce the impact and mortality of breast cancer in our state. Unfortunately, these kinds of interventions are the first thing to go when health care budgets get slashed, because they don’t generate revenue and are not self-sustaining. These kinds of activities need to be funded—either through grants or an external funder, or by the hospitals and health care systems. By narrowly focusing on cost, we risk losing the progress we have made Delaware House Bill 350, as it’s proposed, would cause harm in two ways: First, it would compromise our ability to invest in these kinds of interventions that work. Second, it increases the risk that higher-cost health services and programs that are disproportionately needed by people in vulnerable communities could become no longer available in Delaware. In states where the government has intervened in the name of cutting costs, like Vermont and Massachusetts, we see the consequences–less quality and reduced equitable access to much-needed services. House Bill 350 will widen the gap between those who have means and those who are more vulnerable. These changes will lead to increased disease burden on these populations. They will end up in the emergency room more and hospitalized more, which is by far the most expensive kind of care. That’s not what anyone wants—and it’s the opposite of what this bill was intended to accomplish. At this moment, in Delaware, we have an opportunity to put our state on a sustainable path to better health for all Delawareans. House Bill 350 is not that path. However, the discussion that House Bill 350 has started is something that we can build on by bringing together the stakeholders we need to collaborate with to solve these complicated problems. That includes Delaware’s government and legislators, the hospitals and health centers, the insurance, pharmacy and medical device industries, and most importantly, patients and the doctors who care for them. LeRoi Hicks, M.D., is the campus executive director for ChristianaCare, Wilmington Campus.

LeRoi Hicks, M.D., MPH, MACP

Biography

Dr. LeRoi Hicks is the recipient of numerous clinical and research awards and is nationally known for his research on health care disparities.

His research has been related to three areas:
(1) The effects of patients’ racial and cultural background on the treatment and clinical outcomes of chronic disease;
(2) the development and assessment of interventions aimed at improving quality of medical care and the reduction of disparities in care; and
(3) community-based participatory research to identify and address healthcare disparities.

Areas of Expertise

Social Determinants of Health/Health Disparities
Medicine
Chronic Disease
Internal Medicine
Health Equity

Education

Harvard School of Public Health

MPH

2001

Indiana University School of Medicine

MD

1995

Multimedia

Media Appearances

Poor Health: A Frayed Safety Net

Pittsburgh Post-Gazette  print

2018-04-29

There is no data about how many patients lack access to specialty care. But there are roughly 35 million uninsured Americans and millions more who are underinsured or on Medicaid. All of those people potentially could have difficulty getting specialty care should they need it.

There also is no national data that shows the cost to health systems when poor patients do not go to see a specialist when they need to. What is known is that inpatient care and emergency room treatment are more expensive than outpatient office visits with specialists, and yet for health care providers the current payment system acts as a disincentive to providing specialty care to the poor. A 2013 National Institutes of Health study found that the average cost of a visit to the emergency department in the United States was $2,168. Many specialists charge at least $350, and office visits that involve procedures can cost more.

Leroi Hicks, now vice chair of the department of medicine at ChristianaCare Health System in Delaware and author of the Harvard study, said the main problem is systemic.

"Even now, with all the changes we're going through with health care, we still operate under a system where specialists are operating under a fee-for-service model and not a plan for the patient's overall health," he said. Because of that, "we shouldn't be surprised that doctors who don't get reimbursed for a service don't provide care to people without insurance."

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2017 UMES Physical Therapy grads receive degrees

WESM  

2017-09-15

UMES' pass-rate record is among the nation's best, a fact not lost on Dr. LeRoi Hicks, the commencement speaker, who said he was impressed by graduates' performance he discovered while doing homework on the program.

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Participants of study examining Wilmington's west side can earn up to $75

Delaware Online / The News Journal  print

2017-06-21

Dr. LeRoi Hicks, chair of ChristianaCare's department of medicine and a study organizer, said they've started to realize that only a small amount of what is done in hospitals and clinics actually improves the health of communities.

"We need much more information about what occurs outside of hospitals, particularly for those most vulnerable populations, which include people from high-stressed communities and communities that are traditionally under-resourced," Hicks said.

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Selected Papers and Publications

Observation Status, Poverty, and High Financial Liability Among Medicare Beneficiaries

The American Journal of Medicine

Jennifer N. Goldstein, Zugui Zhang, J. Sanford Schwartz, LeRoi S. Hicks

2018-01-01

Medicare beneficiaries hospitalized under observation status are subject to cost-sharing with no spending limit under Medicare Part B. Because low-income status is associated with increased hospital use, there is concern that such beneficiaries may be at increased risk for high use and out-of-pocket costs related to observation care. Our objective was to determine whether low-income Medicare beneficiaries are at risk for high use and high financial liability for observation care compared with higher-income beneficiaries.

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The Unmet Need for Postacute Rehabilitation Among Medicare Observation Patients: A Single-Center Study

Journal of Hospital Medicine

Jennifer N. Goldstein, J. Sanford Schwartz, Patricia McGraw, Tobias L. Banks, and LeRoi S. Hicks

2017-03-12

Medicare beneficiaries admitted under observation status must pay for postacute inpatient rehabilitation (PAIR) services, out of pocket, at potentially prohibitive costs.

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Cardiovascular Disease and Risk in Primary Care Settings in the United States

The American Journal of Cardiology

Ndumele, Chima D., Heather J. Baer, Shimon Shaykevich, Stuart R. Lipsitz, and Leroi S. Hicks

2012-02-01

Primary care site may play an important role in cardiovascular disease prevalence; however, the distribution of risk factors and outcomes across care sites is not known. In this study, a cross-sectional analysis of 21,778 adult participants from the National Health and Nutrition Examination Survey (NHANES; 1999 to 2008) using multivariate logistic regression was conducted to assess the relation between site of usual care and disease prevalence.

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Event Appearances

A Call to Fix the Least Humane of All Inequities

IU School of Medicine Diversity Week: Leroi Hicks, MD, MPH  Wishard Hospital, Myers Auditorium

2013-01-22