1 ELICA HEALTH CENTERS PRESENTATION SACRAMENTO MEDI-CAL - - PDF document

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ELICA HEALTH CENTERS PRESENTATION SACRAMENTO MEDI-CAL MANAGED CARE ADVISORY COMMITTEE OCTOBER 28, 2019 1. How many Sac County Medi-Cal managed care enrollees are served by your FQHC? Managed Care Member Assignment now exceeds 40,000 members Elica has provided primary care medical integrated with behavioral health and comprehensive

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health services through 103,806 visit for 29,108 unduplicated patients so far in 2019.

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2. What changes has your FQHC made to improve access to care? a. New Sites: i. 1276 Halyard Drive

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ii. 5708 Watt Avenue

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iii. 3234 Marysville Blvd.

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iv. HOW-2/HOW-3 Mobile Units

• (Dental,

Medical and BH services) v. San Juan & Twin Rivers School Districts vi. 5385 Franklin Blvd.

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expansion 2020 vii. 4815 Watt Avenue

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new 2020 viii. +6

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sites under study for 2020-21

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Strategies: i. Dental Services ii. Behavioral Health/MAT iii. 340B Pharmacy iv. Pathways v. Health Homes Program

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Management Expansion vi. Wellspace Referral Agreement: OB-GYN/Adult Dental vii. Practice Transformation

• Patient

Access Initiative viii. Patient First

• Workforce

Development ix. Alternative Capital Financing

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Market Tax Credits c. Success based

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data i. Increased Enrollees by 30% in 2019 ii. Increased Utilization by 50%

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the past two years iii. Should double capacity

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the next five years iv. School Based medical

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efforts in two different schools districts: 1. 421 school age children received wellness exams including vaccines based

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the new regulations. 2. 186 Elica NEW patients met their HEDIS measures in August, 2019. 3. 421 children attended 1st day

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school FY 2019-2020. 3. What strategies is your FQHC employing to improve your quality metrics? a. What specifically are you doing? i. Business Intelligence

• Developing

data infrastructure to improve insights and drive improvement to patient care and business practice. ii. Practice Transformation

• EHR

Optimization iii. Patient First

• Workforce

Development iv. IHAs, AWVs, IPPEs v. Clinic days, (Well Women, diabetic) vi. Diabetic Retinopathy Screening, soon implementing diabetic education group visits

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vii. PHASE Kaiser grant: Preventing Heart Attack and Stroke. viii. OCHIN: HRSA HCCN award to participate as a nonprofit health care innovation center designed to provide knowledge solutions that promote quality, affordable health care for all.

• b. Demonstrated

Success? i. Increase in HRSA quality awards (five

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eight categories) including

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three health centers in the state to receive the health disparities recognition. ii. Earned managed care quality incentives have Increased each

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the last two years. iii. Certified Patient Centered Medical Home (PCMH) under the new 2017 standards and guidelines. Expanding to all sites in 2020. 4. What challenges are you facing? [organize challenges below into these 2 categories] a. Access to Care i. Capital funding

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new sites ii. State licensing & facilities requirements iii. Physician recruitment iv. Workforce development

• b. Quality

i. Data issues

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integrity and data sharing in a timely fashion, no Health Information Exchange ii. Timely Access & Accuracy

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Managed Care (HEDIS, IHA, etc) Reports from Plans/IPAs iii. After claims submission – example: HEDIS updated Reports delayed up to 90 days iv. Members Assignments change from

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Plan

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IPA to another, and it develops issue

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care v. Patient non-compliance

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