from research to policy: building the evidence for community oriented primary health care vicki m....
TRANSCRIPT
From Research to From Research to Policy: Building the Policy: Building the
Evidence for Evidence for Community Oriented Community Oriented Primary Health CarePrimary Health Care
Vicki M. Young, Chief Operating Officer
South Carolina Primary Health Care Association
3 Technology Circle, Columbia, SC 29203
(Phone) 803-788-2778 / (Fax) 803-788-8233 / www.scphca.org
Access to Quality Health Care for All South Carolina
September 27, 2013September 27, 2013
Access to Quality Health Care for All South Carolina
The US CHC Story◦Background◦Where we are, where we’re headed
Parallel Stories: Canadian CHCs and US CHCs
Access to Quality Health Care for All South Carolina
““The Movement”The Movement”
The BeginningThe health center movement began in apartheid South Africa
In the 1950s, Dr. Sidney Kark created the first health center in South Africa
Access to Quality Health Care for All South Carolina
““The Movement”The Movement”
The Beginning• In 1964, the American version was
formed by Dr. Jack Geiger and Count Gibson• occurred when War on Poverty and Civil
Rights Movement were major social issues• funded through the Office of Economic
Opportunity• Included the social and environmental
factors that affect health in communities and by communities
Access to Quality Health Care for All South Carolina
““The Movement”The Movement”
The Beginning• First Two Community Health Centers in
US• Columbia Point- Massachusetts • Mount Bayou- Mississippi
• Focus was to Stimulate Change in Family and Community Knowledge and Behavior • prevention of disease• informed use of available health resources• improvement of environmental, economic and
educational factors related to health
Access to Quality Health Care for All South Carolina
““The Movement”The Movement”
The Beginning• Two-Fold Purpose • Agents of Care • Agents of Change
• Three Elements of the Health Center Model • Community health services• Community economic development• Community participation
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“The test of our progress is not whether we add more to the abundance of those who have much; It is whether we
provide enough for those who have too little.
- Franklin Delano Roosevelt
Access to Quality Health Care for All South Carolina
Federal RequirementsFederal Requirements
Must be a non-profit organization, accessible to all
Community Governance representative of health center patients
Comprehensive, patient- and community-centered across the life cycle
Broad definition of “health”Located in federally-designated
medically underserved areas or serving medically underserved populations
Ongoing needs assessment and quality improvement (QI)
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Federal RequirementsFederal Requirements
Bureau of Primary Health Care (BPHC) requires community health centers to meet 19 Key Health Center Program Requirements
Health Center Program Requirements are divided into four categories:◦ Need◦ Services◦ Management & Finance◦ Governance
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““Where We Are Today”Where We Are Today”
Health Center Funding SourcesMedicaidMedicarePrivate InsuranceFederal Grants (DHHS, HRSA, BPHC)
Patient FeesOther
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““Where We Are Today”Where We Are Today”
2012 Demographics- US Community Health Center
1,198 Health Centers Grantees 21,102,391 Medical Patients Served92.6% of Patients ≤ 200% of Poverty;
71.9% ≤100% of Poverty 36% Uninsured; 40.8% Medicaid; 8%
Medicare13.9% Special Populations Grantees
◦ Homeless◦ Migrant/Seasonal Farm Workers◦ Public Housing◦ School- based◦ Veterans
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“We are only as strong as we are united as weak as we are divided”
- J.K. Rowling
Access to Quality Health Care for All South Carolina
How Did We Get Here?How Did We Get Here?
Advocacy Strategy and Quality Care
Qualitative Data/Evidence Quantitative Data/Evidence
◦ Cost effectiveness◦ Quality evidence-based health care◦ Access
Data Sources◦ UDS◦ Health Disparities Collaboratives data◦ Individual health center stories
Access to Quality Health Care for All South Carolina
How Did We Get Here?How Did We Get Here?
Commitment to working collaboratively at the national, regional/state, and local levels to make the case with available data
Commitment to “Tell Our Story”Recognition of the importance of
research and data in “Telling Our Story”
Recognition that the “right” partnerships with academia and other community partners is key to success
Access to Quality Health Care for All South Carolina
How Did We Get Here? How Did We Get Here?
Commitment by health centers with capacity and interest to engage in health services and outcomes research◦ Comparative Effectiveness◦ Translational/Dissemination◦ Clinical Outcomes
Commitment to explore building capacity for research in the community health center setting
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Where Are We Headed?Where Are We Headed? Assess Health Center Research
Activities and Needs through National Survey◦ Diverse partnership- Clinical and Translational
Science Institute-CN, National Association of Community Health Centers, George Washington University, SC Primary Health Care Association, University of SC
◦ Results 386 respondents (health centers); 35.3% response
rate 55% of respondents indicated that the health
center conducted or participated in research 54% of respondents indicated
interest in participating in research
activities
Access to Quality Health Care for All South Carolina
Where Are We Headed?Where Are We Headed?
National Research Agenda (health center policy)
Patient Complexity and Risk Adjustment
Document Health Center Value◦ Model addresses access, quality, and
cost◦ Comprehensiveness- enabling services
Inform Health Center Growth Strategy
Support Transformation and Health Reform Implementation
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Where Are We Headed?Where Are We Headed?Continue to Focus on and Expand Participation in Health Services and Outcomes Research◦ Comparative Effectiveness◦ Translational/Dissemination◦ Clinical Outcomes
Impact of Non-medical Services and Evidence-based Practices/Programs
Access to Quality Health Care for All South Carolina
Parallel Stories – Parallel Stories – Canada Canada and US and US
Services◦Primary Care◦Enabling
Health Care Service Delivery System◦Comprehensive- Integrated Services◦Patient-centered
Federal Government Involvement/Assistance
Populations Served Data and Research agendas
Access to Quality Health Care for All South Carolina
“I am a strong individualist by personal habit, inheritance and conviction; but it is a mere matter of common sense to recognize that the State, the community, the citizens acting together, can do a number of things better than if they were left to individual action”
- Theodore Roosevelt