(CHI) Community Health Institute and Expo

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.

• - Identify the strategies, data needs, early process and outcome improvements needed to develop and track effective population health management in health centers.
• - Understand the key lessons learned when using a learning community specifically as a performance improvement strategy.
• - Examine how effective population health management can support and demonstrate the outcomes and payments of the value equation from the payer perspective.

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.

• - Understand various approaches for accountable care delivery
• - Recognize best practices for health centers embarking on the accountable care journey
• - Determine important considerations and discussions for a health center considering new models of delivery

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.

• - Understand the reality of the reduction of grants and guidance on planning and preparation for this possibility.
• - Identify the financial revenue streams of a community health center, and tips and hints to help ensure that those revenue streams have been optimized.
• - Identify the regulatory and financial implications of out-of-scope services to understand the pros and cons of that decision.

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.

• - Compare and contrast different workflow models for collecting standardized data on the social determinants of health using PRAPARE.
• - Outline ways to use clinic staff to respond to socioeconomic needs identified through either in-house services or through referrals to community services.
• - Apply strategies to determine which workflow works best in your health center setting.

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.

• - Describe the improvement strategies used in the initiative to improve the care health centers provide LGBT people.
• - Identify common emerging practices that support health centers in identifying and engaging their LGBT patients.
• - Identify common opportunities for improvement that will support health centers in providing culturally responsible, clinically appropriate primary care to their LGBT patients.

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.

• - Recognize the potential benefits of community-oriented primary care projects conducted by medical and dental students.
• - Demonstrate how academic organizations, health centers, and community organizations can work together to improve health and well-being.
• - Appraise programs that address social determinants of health for health centers and communities.

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.

• - Identify the key elements of a succession planning effort.
• - Expand practical knowledge by learning from real health center case scenarios.
• - Utilize existing tools and templates designed to support boards and health center leaders pursuing succession planning now.

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.

• - Inform yourself of elements of a successful mentor program, including the planning, administration, and resources.
• - Identify mentor training and support needed for maintaining successful mentor relationships.
• - Describe "tips" from board member mentors about engaging and retaining consumer board members.

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.

• - Identify the benefits of becoming a teaching institution for entry-level workforce, medical assistants.
• - Understand how to build a pool of hiring candidates for your medical assistant positions.
• - Identify the returns on investing in training students, on-site in your health center setting.

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.

• - Outline a health systems transformation framework that ties together improvement efforts in cancer screening with other clinical and quality areas in support of improved health, quality, and cost.
• - Define effective health center models of risk stratification, care management, care team roles, electronic health record optimization, use of data, and partnerships.
• - Identify opportunities for engaging patients and providers in cancer screening efforts within a health systems transformation approach.

The Health Center Program Requirements provide Federally Qualified Community Health Centers - both 330-funded grantees and Look-Alikes - with a valuable framework and floor on which they can build and enhance their operations. HRSA conducts regular oversight of health centers through Operational Site Visits (OSVs). The OSV provides health centers with an important opportunity to strategically examine and assess their delivery of services, management and finance, governance structure, and how they conduct needs assessments.

This session will provide participants with an overview of how health centers can utilize the OSV preparation process to significantly improve clinical and operational performance. Speakers include leaders from health centers that engaged in a robust internal review process ahead of their OSV. Speakers will share lessons learned from engaging in this process and promising practices for using this process to strategically assess areas in need of greater oversight or improvement. Learn about key trends and patterns that emerge in OSVs and how these can translate into becoming higher performing, innovative providers of comprehensive primary health care services.

• - Describe how health center leaders prepared for their OSVs.
• - Identify best practices for having no or minimal unmet conditions during an OSV.
• - Discuss key trends that reviewers see and areas of concern to address during an OSV.

The FQHC Prospective Payment System, which is cost-based and volume-driven, does not appear to be consistent with the Quadruple Aim and national health care goals. Health centers in several states are looking at new models of payment that focus on population health and outcomes. This session will discuss the goals, structures, and implementation considerations of FQHC alternative payment methodologies (APMs) around the country, as well as other innovative payment systems.

• - Understand the relationship between current health center reimbursement and market trends.
• - Identify inputs for a cost benefit analysis of pay for performance.
• - Perform a high-level calculation of an APM PMPM.

Limited to 50 participants.

HRSA's Operational Site Visits (OSVs) are conducted to assess a Federally Qualified Health Center's compliance with the 19 Health Center Program requirements. While these program requirements are critical to a health center's success, they ultimately provide health centers with a foundation on which they can build high-performing, operationally excellent organizations.

This learning lab provides an in-depth look into the HRSA Operational Site Visit. OSV reviewers and a legal expert will offer their perspectives and insights on performance improvement as a result of OSV trends. Each presenter will describe how high-performing health centers prepare and execute the OSV, and how the preparation process provides a strategic opportunity for health centers to strengthen and improve their overall operations. Presenters include a clinical reviewer, fiscal reviewer, governance and administrative reviewer, and legal expert. The presenters will address the four major areas under review during OSVs - services, management and finance, governance, and need - and discuss promising practices observed at high-performing centers. Time will be reserved for table discussions with both the reviewers and peers from other health centers.

All NACHC Learning Labs are limited in participant space and require special registration. Learning labs are open ONLY to full-paying attendees.

The $25 fee for lab participation partially subsidizes the light refreshments included in all labs. Preregistration and $25 fee required by August 16, 2017. No on-site registration available.

• - Acquire an in-depth look into how OSVs are structured, flow, and executed.
• - Gain direct access to OSV reviewers who can answer health center-specific questions related to OSVs.
• - Identify concrete strategies for having a successful OSV.

This session will address both clinical and policy issues involved in caring for immigrant, refugee, and migrant patients in health centers. Learn from Centers for Disease Control and Prevention (CDC) experts about how primary care clinicians in the U.S. can access overseas vaccination records for their refugee patients and about CDC resources aimed at improving the health of refugees and preventing disease. An attorney with the National Immigration Law Center will highlight important policy developments that health center providers and their patients should be aware of. There will be ample time for discussion.

• - Describe emerging policies that impact the health of immigrants, migrants, and refugees.
• - Identify resources available from the CDC to improve refugee health and prevent disease.
• - Describe how to access refugee vaccination records.

From deeming to claims, ensuring that your health center maintains its Federal Tort Claims Act (FTCA) coverage has never been more challenging. Maintaining FTCA coverage is not easy. The new deeming requirements, involvement of various agencies including HRSA, Office of General Counsel and the Department of Justice, and the increased accountability and responsibility mean that health centers need to pay the closest attention ever to the elements of their FTCA program and claims. In this session, trusted and experienced health center attorneys will discuss the complex multitude of risks in FTCA coverage for health centers. The risks range from being related to their applications and participation, either deeming or redeeming, in the FTCA program, including the new possibility that 330 grant conditions may preclude health centers from receiving their FTCA deeming, to common concerns around the complex set of rules on which FTCA coverage is based. The speakers also will provide information and answer questions about the most up-to-date FTCA "hot topics" that health centers across the country face in the ever-changing healthcare environment, including adding volunteers to your FTCA coverage.

• - Understand the statutory and regulatory basis of the immunity created by the Federally Supported Health Centers Assistance Act.
• - Learn about the significant changes to the FTCA Deeming Application process and corresponding changes to health center FTCA program guidelines.
• - Apply the information to reduce the risk of non-FTCA covered events in their health centers.