The National Health Service Corps (NHSC) and the Teaching Health Centers Graduate Medical Education (THCGME) program help health centers to attract and retain the most talented workforce possible to meet the needs of vulnerable patients and populations. These health workforce programs also provide significant resources such as scholarships, loan repayments, and clinician residency training to ensure that a skilled workforce will be available for health center patients in the future. About half of the NHSC clinicians serve in health centers and nearly half of the 5,000 NHSC-approved sites are community health centers. Mandatory funding for both these programs ended on September 30, 2017 removing $370,000,000 annually in workforce investments in health centers. What has been the impact of these programs going over the cliff? This session will highlight how health centers and their partners have worked to mitigate these impacts and the lessons learned in the process.

Traumatic situations, such as abuse, neglect, experiencing natural disasters, seeing family members impacted by immigration situations, or witnessing violent acts, can affect a child’s development. Health centers can lessen the impact of childhood trauma via the provision of workshops for parents and training for teachers to recognize signs and symptoms, short or long-term counseling, and therapy sessions at various levels. Nationally, we are also seeing long-term champions for children, such as Sesame Workshop and the Robert Wood Johnson Foundation, increase their attention to develop resources in this space. Presenters will discuss their experiences and programs that have proven effective at the health center level, identify resources for providers and families, and engage participants in a robust Q&A on how health centers can lead.  

This session will introduce two new resources related to calculating and benchmarking your health center’s cost of care. The first resource focuses on presenting a methodology for calculating cost of care, including appropriately allocating direct and indirect costs to various services. The second resource presents health center cost of care trends based on UDS data for use as a benchmarking tool, providing comparative data for health centers of various sizes, in urban/rural locations, and based on comprehensiveness of care. Capital Link staff and a health center CFO will discuss the importance of using this information and data in a fee-for-service environment and as the sector transitions to a value-based reimbursement. 

Regardless of whether it is a clinically integrated network, independent practice association, 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 health care 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.   

Capitation in the 1980s, 90s, and early 2000s was used to restrain health care costs and encourage more efficient care of the patient. The caveat is that the participating primary care physicians received this fixed sum for each insured patient regardless of how much care a patient actually received and actually encouraged underutilization. These unintended consequences, operational constraints, and market pressures led to the lack of these capitation arrangements today. As health centers move into more value-based care models and risk-sharing contracts that are incorporating more components of capitation, this history leads to an infrastructure that makes it challenging to be successful as health centers take on more risk. This session will offer lessons learned and how these lessons have been applied to move from the 'old' model to today's adaptation of full capitation in an accountable care framework.  

As health care continues to evolve at a rapid pace, recent events necessitate health centers devote time and resources in order to thoroughly evaluate their operations and surroundings to effectively prepare for increasing expectations and responsibilities. Building on Part 1: Operationalizing the Strategic Plan in the Face of Change and Uncertainty (PThG1), Part 2 will briefly examine the role strategic planning holds in community health centers, and then provide an introduction and overview of the Strategic Planning Toolkit developed in collaboration between NACHC and Capital Link. The toolkit is available to health centers seeking guidance and encouragement in implementing any strategic planning initiative. Whether your health center is new or mature, small or large, or rural or urban, the materials will be applicable to your efforts.

Health center efforts to serve veterans have produced significant numbers of "lessons learned." Sharing these lessons enables other health centers to expand and improve their efforts to provide essential services to veterans in their communities. This session will highlight the work of three health centers who have found ways to serve veterans; they will show what works (and what did not) as well as provide recommendations for how to implement successful veterans-centered programs.