Effective population health management is essential for health centers to flourish in a value-based environment by applying a comprehensive, community-centered approach to improving the health of populations and patients they serve. The aims are to: (1) support CHCs in identifying and engaging an at-risk target population and applying interventions that upgrade processes of care, strengthen local partnerships, and address social determinants; (2) expand population health management capacity to additional patient or community target populations and additional social determinants of health; (3) enhance the potential for sustainability of the interventions, partnerships, and population health capacity; and (4) develop and implement a learning community to share information among grantees and to promote and expand collaboration through information sharing with partners and other audiences. This session will address the strategies, data needs, early process, and outcome improvements in developing and tracking effective population health management in health centers. The audience will hear the lessons learned from RCHN Community Health Foundation and how they utilized their learning community specifically as a performance improvement strategy, with a diverse group of CHCs, that led to specific projects and interventions to produce very favorable outcomes. This session will also provide the payer's perspective on how demonstrated, effective population health management supports the value equation in both outcomes and payments.
Regardless of whether it is a clinically integrated network, independent practice association (IPA), or a unique funding relationship developed between a payer and a single health center, being accountable for the quality and cost of the care provided will be the determining factor for future healthcare delivery success. Because there are so many different ways to design a program, there are equally as many strategies to achieve the shared goals. This session will focus on three such strategies, each taking a different approach and focusing on different aspects of accountable care delivery. Presenters will include representatives from: a health center and critical access hospital partnership; a large health center that developed a program focused on cultivating buy-in at every level and focused on patient satisfaction; and a PCA that has developed both an IPA and Medicare Shared Savings Program using external partners.
This session will provide an overview of health center-tested workflow models for collecting data on the social determinants of health and responding to needs identified using the national, standardized social determinants of health risk assessment protocol known as PRAPARE. A panel of health center staff, who have used PRAPARE, will present the workflow models that they used, ranging from using clinical staff to non-clinical staff (community health workers, patient navigators, etc.) to integrating it with behavioral health. This session will also introduce strategies to help health centers determine which models will work best in their own clinic's workflow.
The community health center (CHC) industry is likely facing the reduction of operating grants in the near future. With that reality facing our industry and other financial challenges looming, thoughtful planning and careful preparation is a must to help ensure that there are minimal or no service disruptions. What other financial resources could be utilized to make up the difference? What services, locations, and programs provide much needed margin to the CHC and which ones reduce financial resources? Are other programs such as 340B, Medicare, and Medicaid reimbursement being utilized to their potential? Should the CHC consider out-of-scope programs and services and what implications are there (both regulatory and financial) to that avenue? Thoughts on these questions and more will be explored during this finance session.
Students at A.T. Still University of Health Sciences are required to conduct community-based research while at a partner health center community campus. Come to this session to show your support and honor these future community healers as they share results of their projects. Learn how you can apply their methods or replicate their programs in your health center.
Health center campsuses where these students did their research include: North Country HealthCare, Flagstaff, AZ; Beaufort Jasper Hampton Comprehensive Health Services, Ridgeland, SC; Family Health Centers at NYU Langone, Brooklyn, NY; ATSU Missouri School of Dentistry and Oral Health, Kirksville, MO; and Northwest Regional PCA, Multnomah County North Portland Health Center, Portland, OR.
In this session, participants will review the basic components of multi-level succession planning and receive tools and templates to apply within their health center settings. Learn from the experiences of health center professionals who have integrated succession planning activities into daily operations, from the perspective of a CHC board member, executive, and training and TA provider. The session will include time for peer-to-peer discussion.
LGBT patients experience unique social determinants of health related to stigma, laws and policies, demographic factors, and barriers to care and have unique health needs that are often not addressed in primary care. Ten community health centers, from nine states, spent one year laying the foundation for culturally responsible, clinically appropriate primary care for their LGBT patients through the use of two improvement strategies: Project ECHO and a Practice Improvement Collaborative.
Together, these strategies encouraged public health and primary care collaboration, supported integrated service delivery models, created communities of practice, and provided clinical knowledge and practice-based improvement strategies to lay the foundation for improved health outcomes for LGBT patients.
In this session, project partners will describe the structure and execution of the initiative; emerging practices for identifying, engaging, and caring for LGBT patients in community health centers; and key challenges and opportunities. A participant health center will describe their experience leveraging care teams, health information technology, organizational leadership, and partnerships to improve the systems supporting the care they provide their LGBT patients.
Mentoring is a relationship in which a more experienced person supports and encourages a less experienced person to maximize their potential, develop their skills, and improve their performance to become the person they want to be. In effective health center governance, the voice of consumer board members is essential to assure the center is responding to community needs and providing patient-centered care. Yet, recruiting and retaining consumer board members can be a challenge for health centers. In this session, participants will learn about developing and monitoring a mentor program to support and encourage participation of consumer board members. In addition, participants will hear lessons learned from fellow health center board members who serve as mentors.
With today's growing emphasis on team-based care and holistic treatment, the role of the medical assistant is expanding and increasing in importance. The ability to hire medical assistants trained to support exceptional team-based primary care is a challenge for practices. Health centers typically hire directly from the communities they serve and are often tasked with filling in the gaps of work-ready skills. These hiring challenges make it difficult to ensure that medical assistants have the skills necessary to perform in the team-based care setting.
Be a part of the transformation! The National Institute for Medical Assistant Advancement (NIMAA), created by Community Health Center, Inc. (Connecticut) and Salud Family Health Centers (Colorado), designed a rigorous transformation of care curriculum that teaches and trains medical assistants on the floors of the community health center. Join us to explore the benefits of becoming a NIMAA Host Clinic and teaching institution. Learn how your teams can gain skills and knowledge by hosting a NIMAA student. See the return on investment for training costs and upskilling employees and how to begin the steps to grow a sustainable pool of hiring candidates. NIMAA: an affordable resource for a medical career pathway in your community.
This session will highlight efforts taking place, in eight health centers across two states, to advance both colorectal and cervical cancer screening within a systems transformation approach. The project focuses on colorectal and cervical cancer screening, as well as hypertension, diabetes, obesity, and depression, all of which are important clinical priorities for health centers and HRSA and reported to the Uniform Data System (UDS). The project's systems transformation approach is based on the Value Transformation Framework developed by NACHC's Quality Center. The Framework organizes the evidence-base and strategies for addressing infrastructure, people, and delivery systems to reach the Quadruple Aim goals of: improved health outcomes, improved patient experiences, improved provider experiences, and reduced costs.