Transforming Clinical Practice

Health and Human Services Secretary Sylvia M. Burwell has announced that the federal agency is awarding $685 million to 39 healthcare collaborative networks to help them improve quality of care, increase patient access to information, and reduce costs at their institutions under the Transforming Clinical Practice Initiative.

“Supporting doctors and other health care professionals change the way they work is critical to improving quality and spending our healthcare dollars more wisely,” said Secretary Burwell in a press release. “These awards will give patients more of the information they need to make informed decisions about their care and give clinicians access to information and support to improve care coordination and quality outcomes.”

The investment aims to provide the tools and support needed to improve quality of care for patients as an overall shift to reward value rather than volume in healthcare. The Transforming Clinical Practice Initiative is one of the largest federal investments designed to support doctors and other clinicians in all 50 states through collaborative and peer-based learning networks;  meaning, learning from one another’s successes or failures.

The Community Health Center Association of Connecticut (CHCACT) is one of the organizations selected to receive the funds –  $17.25 million to provide technical assistance support to help clinicians at  health centers  in Connecticut with the tools, information, and network support they need to improve quality, increase patient access, and spend health care money more wisely.

Evelyn Barnum, CHCACT’s CEO, said in a press release that the program will “focus on improving health outcomes for three conditions common to health center patients: asthma, diabetes and hypertension. Overall, CHCACT expects this investment to improve the health of FQHC patients while saving over $38 million in the health care system.”

Congratulations to CHCACT and all of the other awardees!

To learn more about the Transforming Clinical Practice Initiative and the other awardees, visit the initiative website.

Did your health center or PCA receive funds under this initiative? We want to hear from you! Let us know in the comments below and we will feature you in a future blog post.




Fighting Breast Cancer in Nevada

NHRA Mammovan 10 31 14 2 Interior Picture - Pamela hologicWhen it comes to the Mammovan, what strays in Vegas actually saves lives in Vegas.  We found out about the Nevada Health Centers’ Mammovan from this local National Public Radio story and wanted to learn more. Nevada Health Centers, the largest Community Health Center organization in the state,  operates the 70 foot semi-truck that crisscrosses the state in search of women who need an affordable mammogram.  And in Nevada, there are plenty in need. Only half of women (66 percent) over the age of 40 have had a mammogram in the last two years, and the estimated number of new cases of breast cancer is 1,690 with an estimated 380 expected deaths. That’s 22.5 percent mortality rate (compared to a 13.5 percent mortality rate for all U.S. women) in a state that ranks nearly last (46th) in breast cancer screening rates. The good news is the Mammovan is making a difference while burning up the miles. Since the program started 42,000 women were screened and 200 required further evaluation, of which many were diagnosed. Since 2008 the Mammovan has traveled almost 174,000 miles, but there are still many miles to go to keep saving lives.

“Many insured and uninsured women throughout the state of Nevada feel they don’t have access to breast cancer screenings because of the travel needed just to get screened and don’t feel they can take the time away from family and work,” said  Colleen Petrosky, Mammovan Manager.  “The Mammovan is helping to reach these women and provide hope and support as well as follow-up and referrals when needed.   We know prevention is the best protection and we hear stories from our returning women whose lives were saved because of their Nevada Health Services Mammovan visit.”

About one in 8 women will develop breast cancer in her lifetime and early screenings can make the difference between life and death.

Throughout the month of October–Breast Cancer Awareness Month–we’ll be featuring health centers and people who are waging the battle against breast cancer. If you have a story to share, please tell us and we’ll write about it on this blog.

Creating a Culture of Health

PCMHWe mentioned Cherokee Health Systems (CHS) in our last blog post because they were one of two health centers honored last week in Washington, D.C, by the National Committee for Quality Assurance (NCQA) at their 25th Anniversary Gala. CHS, based in Knoxville, TN, was chosen from a pool of hundreds of organizations across the United States which are working toward improving patient care through the implementation of the Patient Centered Medical Home (PCMH) model, a system of care that emphasizes care coordination and communication among providers. The PCMH model has been shown to result in higher quality care, lower costs of delivering care, and better health outcomes for patients. CHS has been practicing this approach since it was founded in 1960 and is now gaining notice in the media for their integrated model of primary care and behavioral health. HealthLeaders Media focuses  on the health center’s approach in a feature article.

“We’re building a mindset of comprehensive care with primary care and behavioral health providers,” Parinda Khatri, PhD, a clinical psychologist and CCO at CHS tells reporter John Commins. “We believe strongly in access. We say there’s no wrong door,” she says. “People can come through the primary care door and they will be asked about their behavioral health status, they will get behavioral health screenings.

She goes on to describe how the therapists are trained to ask if a new patient has a primary care provider. If not, then the goal of CHS is to be that patient’s medical home and stand ready to talk to him or her about health and how they’re functioning in life. If a patient feels they have a behavioral health issue, at the point of care a behaviorist is brought to them. Whether the issue is substance misuse, depression, smoke cessation, stress management — if there is a request for help it is available on site. No navigating a complex healthcare maze of different providers in different places — at CHS it’s all under the same roof and designed to ensure the patient gets the help they need as soon as they need it. Best of all, the providers, whether it is the doctor or therapist, are all communicating with each other about the patient’s needs.

This seems like a common sense approach, unfortunately, it is not a commonplace approach in healthcare — unless of course one happens to visit a Community Health Center.


Health Centers Honored for High Quality Care

Paul Kaye, MD, of HRHCare at the NCQA Gala in Washington, D.C.

Paul Kaye, MD, of HRHCare at the NCQA Gala in Washington, D.C.

Deb Murph, CEO of Cherokee Health Systems

Deb Murph, CEO of Cherokee Health Systems at the NCQA Gala in Washington, D.C.

We are so proud of our friends at HRHCare (Hudson River HealthCare) in New York and Cherokee Health Systems  (CHS) in East Tennessee. Both health centers were  honored this week in Washington, D.C, by the National Committee for Quality Assurance (NCQA) at their 25th Anniversary Gala.  NCQA is a private, nonprofit organization dedicated to improving healthcare quality.

“As we celebrate our own 40th Anniversary this year, HRHCare is so proud to be recognized as a lead organization providing high quality health care for all by the NCQA during their 25th Anniversary celebration,” said Anne Kauffman Nolon, MPH, President and CEO of HRHCare in a press release. “Having achieved Level 3 PCMH status from the NCQA is a testament to the mission of HRHCare to provide outstanding, compassionate care to the patients we serve.”

The secret formula to their success?  Plan. Do. Study. Act. If you want to know what these words have to do with healthcare delivery, watch this great video by NCQA about HRHCare and see how this organization  isn’t afraid to try out bold ideas.

Paul Kaye, MD, Executive Vice President of Practice Transformation at HRHCare, accepted award on behalf of HRHCare at the NCQA Gala. Previously serving as Chief Medical Officer of HRHCare for 21 years, Dr. Kaye was instrumental in helping HRHCare achieve Level 3 PCMH recognition.  Some 22 HRHCare Health Centers now hold the highest PCMH status of Level 3, a recognition that establishes HRHCare as a medical home that focuses care coordination and communication to transform primary care into what patients need and want it to be.

HRHCare started nearly 40 years ago. Founded in 1975 to provide care to the medically underserved population of Peekskill, the health center organization has grown to include 29 health centers delivering care throughout a 10 county region of 135,000 patients with over 1,000 employees and 350 health care practitioners. Their services include adult and pediatric care; obstetrical and gynecological care; family planning; HIV counseling, testing and referral; dental services; mental health counseling; nutrition counseling; podiatry; WIC services; health education; and a full complement of outreach, translation, transportation, benefits counseling and health insurance enrollment assistance.

CHS, which operates in 18 locations around East Tennessee, was also honored for  ground-breaking work using a whole health approach that blends in behavioral health services to address the psychological, social and environmental factors that affect overall health, as described in this NCQA video.  The work they do is especially noteworthy given the challenges of the patient population they serve, which includes migrant farmworkers and a growing homeless population.

We congratulate these leaders in community health!


The Cost of ER Visits

ED Fact SheetHow many times in the last year have you or a family member visited the hospital emergency room? For millions of medically underserved who do not have access to a doctor, a visit to the ER is all too often the only way to get care even for the most ordinary maladies.  Nearly forty percent of emergency department (ED) visits among the general population are primary care sensitive in nature and thus preventable.  According to the National Hospital Ambulatory Medical Care Survey (NHAMCS), 10 percent of all ED visits are non-urgent because they do not require immediate medical attention.   So why seek care at a hospital when a regular primary care provider will do?  There may not be any available or nearby.

A recent article in The Herald Mail Media notes that many preventable emergency department visits happen because patients could not access timely primary care.  Access to a primary care provider is indeed a problem in the U.S.  Some 62 million people are at risk for health issues because they do not have access to regular primary care provider, according to NACHC.  Some 43 percent of these medically underserved are low-income people, 28 percent live in rural areas, and many do have insurance, whether it is private coverage or Medicaid.  The real issue is having a regular place to go for care to stay healthy and out of the hospital.  Not having that option for primary care can prove expensive.  Consider this: the average cost per health center medical visit was less than one-sixth the average cost of one ED visit.

To learn more about health centers and their role in reducing hospital ED use read this NACHC fact sheet.