achieving affordable community-based health care for oklahomans presented by oklahoma primary care...
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Achieving Affordable Achieving Affordable Community-Based Community-Based
Health Care for Health Care for OklahomansOklahomans
Presented byPresented byOklahoma Primary Care AssociationOklahoma Primary Care Association
HRSA/BPHC State Liaison HRSA/BPHC State Liaison
Strengthening access to affordable Strengthening access to affordable community-based health care through community-based health care through
advocacy, education, and technical advocacy, education, and technical assistanceassistance
Oklahoma Primary Care AssociationOklahoma Primary Care Association
America’s Health Structure America’s Health Structure 20102010
Tertiary Care
Secondary Care
Primary Care
Oklahoma Primary Care AssociationOklahoma Primary Care Association
An Ounce of Prevention…An Ounce of Prevention…Cost Effective and Better Patient Cost Effective and Better Patient
OutcomesOutcomes
Tertiary Care
Secondary Care
Affordable Primary Care
Oklahoma Primary Care AssociationOklahoma Primary Care Association
Oklahoma Ranks 50Oklahoma Ranks 50thth in in 20092009
http://www.commonwealthfund.org/Maps-and-Data/State-Scorecard-2009/DataByState/State.aspx?state=OK
Oklahoma Primary Care AssociationOklahoma Primary Care Association
What are CHCs/FQHCs?What are CHCs/FQHCs?
330 Community Health Centers (CHCs), initially 330 Community Health Centers (CHCs), initially referred to as “Neighborhood Health Centers,” referred to as “Neighborhood Health Centers,”
are an outgrowth of President Lyndon B. are an outgrowth of President Lyndon B. Johnson’sJohnson’s
Great Society Program,Great Society Program, in 1966. in 1966. CHCs, as public/private partnerships, CHCs, as public/private partnerships,
receive Section 330 grant fundsreceive Section 330 grant fundsto provide affordable health care to to provide affordable health care to
individuals at or below 200% FPL.individuals at or below 200% FPL.
Note: FQHC is a status given to 330-funded Note: FQHC is a status given to 330-funded CHCsCHCs
Presidential Initiatives to Presidential Initiatives to Improve America’s HealthImprove America’s Health
2001-2008: President Bush2001-2008: President Bush Double the number of patients served in Community Double the number of patients served in Community
Health Centers (CHCs) within 5 yearsHealth Centers (CHCs) within 5 years
* CHC patients have increased from 10 million to more * CHC patients have increased from 10 million to more than 18 million; dental services have doubled and than 18 million; dental services have doubled and behavioral health increased 170%behavioral health increased 170%
Increase current total of 3,200 CHCs by 1,200 to reach Increase current total of 3,200 CHCs by 1,200 to reach goal of 4,400 CHCs at the end of 5 yearsgoal of 4,400 CHCs at the end of 5 years
* Goal of 1,200 was reached – at 1278 end of 2008 * Goal of 1,200 was reached – at 1278 end of 2008
2009-present: President Obama2009-present: President Obama Funded 126 new sites; $250M for 350 sites in FFY2011Funded 126 new sites; $250M for 350 sites in FFY2011
Oklahoma Primary Care Association
2010 Oklahoma CHC Presence2010 Oklahoma CHC PresenceOver $18.6 million in additional CHC grant dollars to OK since 2001!Over $18.6 million in additional CHC grant dollars to OK since 2001!
Oklahoma Primary Care Association
4300 N. Lincoln Blvd., Ste. 203Oklahoma City, OK 73105
405.424.2282 Fax 405.424.1111Copyright 2001-2009 OKPCA. This publication was made possible by Grant Number U58CS06840 from Health Resources & Services Administration (HRSA)/Bureau of Primary Health Care (BPHC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the HRSA/BPHC.
Section 330 CHC Core Section 330 CHC Core TenetsTenets
Serve areas of highest Serve areas of highest needneed Provide comprehensive Provide comprehensive primaryprimary care to care to
people of all life cycles; including provision of people of all life cycles; including provision of oraloral and and behavioral healthbehavioral health services services
Must serve all people regardless of Must serve all people regardless of abilityability to to pay pay
Patient-majority governing boardPatient-majority governing board that that oversees public/private partnershipoversees public/private partnership
Must meet Must meet performance & accountability performance & accountability requirementsrequirementsMust adhere to BPHC PIN 98-23 – Program Expectations
88Oklahoma Primary Care AssociationOklahoma Primary Care Association
Required Financial Required Financial Performance MeasuresPerformance Measures
Total Cost Per Patient (UDS) Total Cost Per Patient (UDS) Medical Cost Per Medical Encounter Medical Cost Per Medical Encounter
(UDS)(UDS) Change in Net Assets to Expense Ratio Change in Net Assets to Expense Ratio
(Audit)(Audit) Working Capital to Monthly Expense Working Capital to Monthly Expense
Ratio (Audit)Ratio (Audit) Long Term Debt to Equity Ratio (Audit)Long Term Debt to Equity Ratio (Audit)
Oklahoma Primary Care AssociationOklahoma Primary Care Association
Oklahoma Primary Care AssociationOklahoma Primary Care Association
Required Clinical Required Clinical Performance MeasuresPerformance Measures
Quality/Risk ManagementQuality/Risk Management1.1. % of first trimester prenatal care% of first trimester prenatal care2.2. Immunization rates for two-year oldsImmunization rates for two-year olds3.3. % of women receiving Pap tests% of women receiving Pap tests
Health Outcomes/DisparitiesHealth Outcomes/Disparities4.4. % of diabetic patients with HBA1c levels < or = 9%% of diabetic patients with HBA1c levels < or = 9%5.5. % of hypertensive patients with BP less than 140/90% of hypertensive patients with BP less than 140/906.6. % of births < or = to 2,500 grams (approx. 5 lbs,8 oz)% of births < or = to 2,500 grams (approx. 5 lbs,8 oz)
Plus…Plus…7.7. One self-identified Oral Health MeasureOne self-identified Oral Health Measure8.8. One self-identified Behavioral Health MeasureOne self-identified Behavioral Health Measure
Oklahoma Primary Care AssociationOklahoma Primary Care Association
In 2009, Oklahoma CHCs …In 2009, Oklahoma CHCs …
Source: BPHC, HRSA, DHHS, 2009 Uniform Data System, 17 Grantees
Served 118,810 patients Served 118,810 patients Generated 396,672 total Generated 396,672 total
patient visitspatient visits 46% of patients were uninsured46% of patients were uninsured 46,994 patients were at or 46,994 patients were at or
below Federal Poverty Level below Federal Poverty Level (FPL)(FPL)
Over 68% were at or below Over 68% were at or below 200% FPL (known status)200% FPL (known status)
OK CHC Revenue OK CHC Revenue by Source - 2009by Source - 2009
Federal Grant - 34.04%Federal Grant - 34.04% Self-Pay – 25.13%Self-Pay – 25.13% Medicaid – 25.16%Medicaid – 25.16% Medicare – 9.74%Medicare – 9.74% Other 3Other 3rdrd Party - .09% Party - .09%
Oklahoma Primary Care AssociationOklahoma Primary Care Association
Source: BPHC, HRSA, DHHS, 2009 Uniform Data System, 17 Grantees
Oklahoma Primary Care AssociationOklahoma Primary Care Association
OK CHC Patients by AgeOK CHC Patients by Age
Aggregate Totals for OK CHC Grantees – Varies by CHCSource: BPHC, HRSA, DHHS, 2009 Uniform Data System
% of OklahomaOK CHC Population
Age Population In Age Group ‘090-5 12,408 10%5-14 13,459 11%15-19 8,141 7%20-44 43,462 37%45-64 31,221 26%65+ 10,119 9%
118,810 100%
Full-Time Equivalent Employees:Full-Time Equivalent Employees:
723.31723.31
Federal Grant Dollars Returning to Oklahoma: Federal Grant Dollars Returning to Oklahoma:
$25.29 Million$25.29 Million
Health Center Total Costs Excluding Health Center Total Costs Excluding Donations:Donations:
$66.65 Million$66.65 Million
Direct Impact in OklahomaDirect Impact in Oklahoma(2009 – 17 Grantees)(2009 – 17 Grantees)
Oklahoma Primary Care AssociationOklahoma Primary Care Association
Collaboration to Protect Collaboration to Protect the Investment & Improve the Investment & Improve
HealthHealth Coordination between HRSA grantees Coordination between HRSA grantees
(including CAHs & RHCs) to avoid duplication(including CAHs & RHCs) to avoid duplication Work with other neighborhood groups to Work with other neighborhood groups to
deliver servicesdeliver services Support letters to demonstrate working Support letters to demonstrate working
relationships with other health care providersrelationships with other health care providers Leveraging resources and use of technology Leveraging resources and use of technology
to strengthen local health care systems & to strengthen local health care systems & improve patient outcomesimprove patient outcomes
Oklahoma Primary Care AssociationOklahoma Primary Care Association
Commonwealth Fund Commonwealth Fund 2009 State Scorecard:2009 State Scorecard:
Cross-Cutting Highlights & Cross-Cutting Highlights & ThemesThemes
Oklahoma Primary Care AssociationOklahoma Primary Care Association
Symptoms of poor care coordination and inefficient or suboptimal use of resources point to opportunities to improve both quality and cost.The State Scorecard points to evidence of gaps in care and fragmented care that reflects health system dysfunction: the failure to provide timely and effective preventive and chronic care; high and, in many states, increasing hospital readmission rates; and rising hospitalization rates for nursing home residents and home health care patients across most states. Despite improvement, rates of potentially preventable hospitalizations remain relatively high in many states. And the gaps in receipt of recommended preventive care such as cancer screenings and immunizations across states underscore the need for a stronger primary care infrastructure in the United States.
Oklahoma Primary Care Association Oklahoma Primary Care Association Oklahoma’s Medically Underserved Areas by County With Safety-Net Resources Oklahoma’s Medically Underserved Areas by County With Safety-Net Resources
(Community Health Centers, Rural Health Clinics and Critical Access Hospitals) (Community Health Centers, Rural Health Clinics and Critical Access Hospitals)
Sources: HRSA, OKPCA & ESRI
Oklahoma Primary Care AssociationOklahoma Primary Care Association
ResourcesResources
www.okpca.org
www.bphc.hrsa.gov
www.nachc.com
For further information, contactJudy Grant
Director of Community DevelopmentOklahoma Primary Care Association
4300 N. Lincoln Blvd., Ste. 203Oklahoma City, OK 73105
(405) 424-2282, Ext. [email protected]