An Introduction to MPCA and Federally Qualified Health Centers~ - - PowerPoint PPT Presentation
An Introduction to MPCA and Federally Qualified Health Centers~ Partners for Quality Care AIM Partnership Forum June 5, 2014 Lynda C. Meade, MPA Director of Clinical Services Michigan Primary Care Association www.mpca.net Overview
An Introduction to MPCA and Federally Qualified Health Centers~ Partners for Quality Care
AIM Partnership Forum June 5, 2014
Lynda C. Meade, MPA Director of Clinical Services Michigan Primary Care Association
www.mpca.net
Overview
Michigan Primary Care Association Michigan Health Centers Clinical services Health status of health center patients The Affordable Care Act and Health
Centers
Who Is MPCA ?
Michigan Primary Care Association Membership Association Governed by a Board of Directors Receives grants and contracts from state and federal
agencies
Supports and advocates for expansion of primary
care in underserved communities
Provided technical assistance and services across a
full spectrum of topics/interests 54 Primary Care Associations nationwide
Who are the FQHCs?
Federally Qualified Health Centers (FQHC) is used
as an umbrella term for a number of safety-net programs and refers to how they are reimbursed by Medicaid
roots in the Migrant Health Act of 1962 and the Economic Opportunity Act of 1964,
War on Poverty
Care has been in operation since 1967
and/or underserved population
38 Health Centers
provide care for more than
600,000 residents
at over 230 delivery sites across Michigan
Specialty Care in Michigan
Migrant/Seasonal Farmworkers Health
Homeless Health
Public Housing
Indian Health Services (2 sites/12 tribes) Schoolbased 21,623 served Veterans 9,952+ served HIV/AIDS (2 Ryan White Clinics)
The fundamental principles on which they were established over 45 years ago set them apart from other providers of health care:
Health Centers are Health Centers are
Located in or serve medically underserved areas or populations Located in or serve medically underserved areas or populations
Provide comprehensive primary health care services as well as support services that promote access to health care Provide comprehensive primary health care services as well as support services that promote access to health care Provide services available to all with fees adjusted based on ability to pay Provide services available to all with fees adjusted based on ability to pay Governed by a community board composed of 51 percent or more of Health Center patients who represent the population served Governed by a community board composed of 51 percent or more of Health Center patients who represent the population served Meet strict performance and accountability requirements regarding administrative, clinical, and financial operations as established by the federal government Meet strict performance and accountability requirements regarding administrative, clinical, and financial operations as established by the federal government
Michigan Health Center Patients
Michigan UDS 2011
546,245 450,000 475,000 500,000 525,000 550,000
2007 2008 2009 2010 2011
462,31
Patients by Age - Statewide
Under 5, 10.9% 5 to 12, 16.6% 13 to 17, 8.3% 18 to 24, 9.6% 25 to 64, 48.3% 65 and Older, 6.3%
Patients by Insurance Status - Statewide
Percentage of T
Michigan UDS 2012
45.4% 31.8% 13.4% 9.2% 0.2%
Medicaid/CHIP Uninsured Private Medicare Other Public
Patients by Ethnicity- Statewide
Percentage of T
14.4% 85.6%
Hispanic/Latino Non-Hispanic/Latino
Health Center Staffing
Practitioner Type Number of FTEs Physician 230 Mid-Level 190 Nurse 305 Dentist 107 Mental Health 80 Enabling 272
* Total does not include FQHC Look- Alikes. 230 190 305 107 80 272
Physician Mid-Level Nurse Dentist Mental Health Enabling
Health Center Patients*
13,000 With Asthma Nearly 30,000 With Diabetes Over 48,000 With Hypertension Additional 7,000 with Heart Disease Additional 6,500 with Chronic Bronchitis
and Emphysema
20,000 Diagnosed With Depression, 12,000
With Anxiety Disorder
45,000 Required Restorative Dental, Nearly
40,000 Oral Surgery
* 2012
Today more than 600,000 Michigan residents rely on a Health Center as their health care home—including individuals who are low income, uninsured, underinsured, elderly, minority, migrant and seasonal farmworkers, homeless, and those living with HIV/AIDS.
Increased Access to Increased Access to
FQHC Growth Strategies
New Access Points Expanded Medical Capacity Service Expansion Change in Scope Facility Expansion Enabling Services Collaboration &
Partnerships
THE AFFORDABLE CARE ACT AND HEALTH CENTERS
The Need for Health Centers Post- ACA
Today, approximately 1,200 Health
Centers operate nearly 9,000 service delivery sites across the country
comprehensive health care services at Health Centers, regardless of income level
Projected 30 million individuals will gain insurance through the Marketplace and Medicaid under ACA
Health Centers and the ACA
Having an insurance card does NOT
ensure access to care
Despite passage of the ACA and Medicaid
expansion, many individuals will remain uninsured
important role as safety net providers for those remaining uninsured
CHC Expansion
$11 billion for new Health Center
Program Expansion FY2011-2015
capital needs
Michigan received 9 New Access Point
Awards (NAP) in 2013 that will serve 42,000 new patients
available now
Coverage Expansion
Medicaid Expansion through the Healthy Michigan Plan: Potential 500K new Medicaid patients of which over 100K are Health Center patients Insurance Marketplace: Requires that health centers receive fair reimbursement from insurers
exchanges
Health Centers and the ACA
Health Centers are economic engines in
the communities they operate
for residents
revitalization
Proven track record of educating
community members about overall health, health care services, and insurance
Health Information Technology
Electronic Health Records Patient Registry Patient Management System Meaningful Use T
elemedicine/mobile health
Outreach and enrollment (CMS Innovation)
33 of 36 (92%) health centers have EHR
Nationally 90% of Health Centers have EHRs (Others 72%)
12 of 36 refer dental services out
66% of agency have EDR if offering oral health services
HIT Critical to cost, experience and quality in truly transformed health care!!
Quality, Cost, Patient Experience
Health care triple aim Healthy People 2020 driven goals Payment based on health status and
Management of data critical Health status is a team sport and everyone
plays a role
Innovation is a must…..
What is the PCMH?
A PCMH puts patients at the center of the
health care system, and provides primary care that is “accessible, continuous, comprehensive, family centered, coordinated, compassionate, and culturally effective.” (American Academy of Pediatrics)
Joint Principles of the PCMH
Adopted by AAFP, ACP, AAP, AOA:
Status of PCMH in Michigan Health Centers
100% 40% 50% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% HRSA Goal by 2017 All Health Centers Status in U.S. Health Centers Status in Michigan Note: Based on 36 Health centers (excluded New starts)
Measurement
Alignment: Healthy People 2020 HEDIS HRSA Clinical Core Measures Guidelines MQIC
Uniform Data System & HP2020
Percent Low Birth Weight Babies Percent Patients with controlled Hypertension Percent Patients with Controlled Diabetes Percent Patients with Prenatal Care in 1st Trimester Percent Immunized Children Percent Females Screened for Cervical Cancer Percent Patients Assessed for Tobacco Use Percent Patients Who Received Tobacco Cessation Intervention Percent of Adult Patients with BMI Charted and Follow Up Percent of Adolescent Patients with weight counseling and BMI Documented Percent of Patients with Acceptable Asthma Treatment Plan Percent of Patients with Appropriate Sceening for Colorectal Cancer60.00% 62.00% 64.00% 66.00% 68.00% 70.00% 72.00% 74.00% Percent of Patients with Acceptable Asthma Treatment Plan MICHIGAN FQHC AVERAGE NATIONAL FQHC AVERAGE
Asthma Data
2012 2011 2010 2009 Asthma Patients 27,182* 13,130 14,141 13,445 Asthma Visits 46,695* 20,529 22,280 21,944
*From the 2012 UDS Manual: “Table 6A has been significantly revised for data submitted for CY 2012 and years thereafter. In the past focus exclusively on PRIMARY DIAGNOSES. Beginning with 2012 report on all
VISITS
with the designated diagnoses and all patients who received this diagnoses, regardless of whether it was a primary diagnosis, a secondary diagnosis, a tertiary diagnosis, or any other level.
Recent MDCH Program/Project Partnerships
Cervical, Colorectal, Ovarian Cancer Immunizations HIV Hep C Oral Health Perinatal 4X4 Task Force Developmental screening Emergency management Diabetes STD
Opportunities
Communication Education Resources Alignment Data sharing Advocacy Other……..
Questions?
For further information, please contact:
Lynda Meade, MPA
Director of Clinical Services 517-827-0740 (direct) lmeade@mpca.net www.mpca.net