Transcript Document

2013 NACHC WINTER STRATEGY MEETING
HEALTH
CENTERS
A
SOLUTION
OF
CHOICE
2013 NACHC WINTER STRATEGY MEETING
CHARGE
All components of the health center movement
must continue to work together on policy issues
while helping build the capacity to respond to a
changing health care marketplace and ensure
health center operations are efficient and
effective.
Develop a clear set of time specific actions that
enable NACHC, PCAs, Networks & Health
Centers to lead the way in achieving positive
results related to access, quality, and cost.
HEALTH CENTER ASSETS AND VULNERABILITIES
ASSET
VULNERABILITY
• Expertise in serving
vulnerable populations -services under one roof;
staff with cultural/ linguistic
competencies
• Improve the patient
experience or lose patient
loyalty
• Relationship with
patients/communities we
serve - we know them best
& can communicate with
them
• Lack detailed outreach,
enrollment, and navigation
strategies
HEALTH CENTER ASSETS AND VULNERABILITIES
ASSET
• Existing programs, e.g.,
NHSC, help retain and
recruit providers
VULNERABILITY
• Strong competition,
including inability to match
salaries offered
• Have the data to make the
health center value
proposition
• Not using the data we have
to its full potential, e.g.,
comparative performance
analysis
• Largest primary care
network (patients,
providers, etc.) – a
“precious” commodity
• Don’t act like a “precious
commodity”; improve
alignment and use of
assets
HEALTH CENTER ASSETS AND VULNERABILITIES
ASSET
• Knowledge of Medicaid;
flexibility to experiment with
APMs
VULNERABILITY
• Limited Medicaid partnerships; dependent on
payment model that is
bound to change
• PCMH, including
experience with EHRs,
chronic care management
and service integration
• Care coordination and
behavioral health capacity
need to be increased
• Consumer-based boards
• Consumer-based boards –
without proper training,
development, and
communication, become a
liability
• ETC.!
• ETC.!
2013 NACHC WINTER STRATEGY MEETING
CROSS-CUTTING CONCERNS
1. UNITY – “We are all stronger when we stand
together and act together!”
2. DATA – We have data that we are not using to
define performance measures and compare
performance.
3. PATIENTS – “Our patients are potentially
someone else’s enrollees!”
4. STAFF AND BOARDS – We must ensure that
our staffs and board members are well
informed.
2013 NACHC WINTER STRATEGY MEETING
CROSS-CUTTING CONCERNS
5. TRANSFORMATIONAL LEADERSHIP –
“NACHC and the health center movement must
embrace transformational leadership as a core
value…”
6. SENSE OF URGENCY – We must create a
sense of urgency that results in health centers
being a major and trusted source of essential
information for their patients, community,
legislators, partners, etc.
2013 NACHC WINTER STRATEGY MEETING
RECOMMENDED ACTIONS FOR REACHING
ALL HEALTH CENTERS
1. Message reinforcement via NACHC and PCA
meetings and communications.
2. Sharing of patient stories, best practices and
lessons learned.
3. NACHC and PCAs target and reach out to those
health centers that are not active participants in
either or both associations – including “a buddy
system.”
2013 NACHC WINTER STRATEGY MEETING
RECOMMENDED ACTIONS FOR REACHING
ALL HEALTH CENTERS
4. Regular updates presented to NACHC, PCA,
and Network board members.
5. Communication strategy that uses more than
usual venues – maximize social media.
6. Use other forums to reach staff other than health
center CEOs (CFO trainings, clinician trainings,
board member trainings, etc.).
2013 NACHC WINTER STRATEGY MEETING
HEALTH CENTER OPERATIONS
For health centers to be both providers of
choice and employers of choice, they must
be able to operate efficiently and
effectively and be able to document impact
on quality and cost. What actions are
required for health centers to operate
successfully in the new health care
environment?
2013 NACHC WINTER STRATEGY MEETING
GROUP A
Outreach/Enrollment: current and
prospective patients
What should health centers be doing to
keep existing patients and attract newly
insured patients?
2013 NACHC WINTER STRATEGY MEETING
GROUP A RECOMMENDED ACTIONS
• Tools, rooted in a client-driven belief system, that
inform staff, patients and communities of ACA and
reflect health centers as reliable sources of patient
advice
• State-focused resources that enable PCAs to
work with state legislators/regulators to ensure
health centers are viewed favorably
• Client empowerment/navigation tools that can
assist existing and potential health center patients
identify that they are with a “community health
center”
2013 NACHC WINTER STRATEGY MEETING
GROUP B
PCMH Model
Including clinical workforce
How do we get to at least 40% of health
centers recognized as PCMH by 2014
and what are the clinical workforce
implications of doing that?
2013 NACHC WINTER STRATEGY MEETING
GROUP B RECOMMENDED ACTIONS
• Segment and target at least 288 health centers to
be PCMH recognized by 2014
• Target health centers already recognized/
accredited to sustain practice transformation and
outcome documentation
• Develop a framework to coordinate PCMH training
and TA
• Develop business case and practical models for
sustainable PCMHs, and demonstrate clear and
intuitive value for health centers, payers, and
stakeholders
2013 NACHC WINTER STRATEGY MEETING
GROUP C
Leadership:
Management teams and boards
How do we work to retain, recruit, and
create strong leadership at health
centers?
2013 NACHC WINTER STRATEGY MEETING
GROUP C RECOMMENDED ACTIONS
• Acknowledge that leadership development is a
strategic priority on par with advocacy efforts
• Develop a “plan for enhanced leadership” that
reflects innovation and transformational leadership
• In concert with PCAs and Networks, execute the
Plan across the country
2013 NACHC WINTER STRATEGY MEETING
GROUP D
Efficient and Effective
Operational Systems
What business tools, e.g., financial
benchmarks, patient flow analysis,
practice improvements, etc., are needed
to have business and clinical practices
that produce sufficient resources to
ensure stable operations?
2013 NACHC WINTER STRATEGY MEETING
GROUP D RECOMMENDED ACTIONS
• Develop a methodology and training to assist
health centers track/monitor/explain total costs
• Develop tools related to practice redesign –
principles, techniques, best practices, etc.
• Convene Networks and PCAs to develop strategy
on how to engage health centers not yet involved
in networks or data warehouses
• Develop and implement strategy for consistency
or integration across organizations hosting data
warehouses
2013 NACHC WINTER STRATEGY MEETING
MARKETPLACE
Ultimately, success in this area will require that
health centers are appropriately recognized in
new payment arrangements, i.e., both Medicaid
Expansions and State Insurance Exchange
offerings, and have entered into strategic
partnerships with other groups in the health care
industry. What actions are required to assist
health centers to be successful in what will
continue to be a changing and challenging health
care marketplace?
2013 NACHC WINTER STRATEGY MEETING
GROUP E
Partnerships
and Linkages
What actions can be taken to assure
that health centers are forming
appropriate partnerships/linkages and
executing contracts that allow for
success?
2013 NACHC WINTER STRATEGY MEETING
GROUP E RECOMMENDED ACTIONS
• Develop training, tools, and best practices to
assist with negotiations
• Promote a national payment model that allows
payers to risk adjust for social determinants of
health
• Identify and remove HRSA roadblocks regarding
mergers, change of scope, and other innovative
approaches to care that require HRSA approval
2013 NACHC WINTER STRATEGY MEETING
GROUP F
Insurance Exchange
Implementation
What are the practical health center
operational strategies that will enable
them to maximize opportunities of
participating in the new State Insurance
Exchanges?
2013 NACHC WINTER STRATEGY MEETING
GROUP F RECOMMENDED ACTIONS
• Define timelines and decision trees for State Exchanges that
clearly articulate the process moving forward (including key
dates) and how health centers and patients will be impacted
• Develop a curriculum for training health center staff on State
Exchanges to be carried down to patients via health center
staff
• Advocate at federal/state levels for additional health center
funding for Outreach, Enrollment, and Navigator purposes
• Promote and disseminate information on IPA and ACO state
and/or local best practice models
2013 NACHC WINTER STRATEGY MEETING
GROUP G
Strategic Understanding
and Positioning
What can be done to assure that all
health centers recognize, understand,
and are positioned to take advantage of
the ACA opportunities?
2013 NACHC WINTER STRATEGY MEETING
GROUP G RECOMMENDED ACTIONS
• Develop internal and external analytical tools to
inform strategic decision-making
• Strengthen health center brand identity, i.e.,
F – fees based on ability to pay
Q – quality health care to all people regardless of
insurance status
H – highly competitive health care professional teams
C – community controlled by patient majority boards
2013 NACHC WINTER STRATEGY MEETING
POLICY
Our responsibility is to inform all members
of the health center movement, including
patients, of what is at stake and provide
them with a direction of how to proceed.
What actions are needed to inform and
mobilize all parts of the health center
movement to deliver the value proposition
of health centers to elected officials and
policy makers?
2013 NACHC WINTER STRATEGY MEETING
POLICY: Taking It To The Street
We must have a UNIFIED message for all
levels of officials
• This includes federal, state, and local officials
• For advocate champions and new advocates
alike
• Legislative, regulatory, and all policy-related
actions
2013 NACHC WINTER STRATEGY MEETING
GROUP J
Negotiating State
Medicaid Payments
What will it take to effectively work with
State officials to ensure that the
Medicaid Expansions have appropriate
reimbursement?
2013 NACHC WINTER STRATEGY MEETING
GROUP J RECOMMENDED ACTIONS
•
•
•
Create a method for sharing state negotiations
regarding Medicaid payments in real-time
Collect data to develop risk adjustment models
recognizing the social determinants of health
Expand training on new and existing payment
models
2013 NACHC WINTER STRATEGY MEETING
GROUP I
State/Federal
Regulatory Policies
How do we prioritize and respond to
critical state and federal regulatory
policies that will define the actual
details of how Medicaid Expansions and
State Insurance Exchanges will
operate?
2013 NACHC WINTER STRATEGY MEETING
GROUP I RECOMMENDED ACTIONS
•
•
•
Continue to support appropriate payment
methodologies within CMS
– Medicaid
– Exchanges
– CMS demonstration projects
Ensure HRSA & CMMS regulatory policies are
timely
– “The bureaucracy should respond at the
speed of the marketplace”
Align consistent messages with our policy
agenda
2013 NACHC WINTER STRATEGY MEETING
GROUP H
Elected Officials:
Value proposition of health centers
What actions are needed to educate
elected officials, including those at the
state and local levels, on the role health
centers can play as we move forward,
including what the health return on
investment is?
2013 NACHC WINTER STRATEGY MEETING
GROUP H RECOMMENDED ACTIONS
•
•
•
Build “Key Contact” infrastructure and program
Arrange in-house visits at CHCs for every
federal, state, and local elected official, every
year
Raise visibility of advocacy at all meetings
2013 NACHC WINTER STRATEGY MEETING
Thank you, Group Leaders!
Mark Bryant
Mary Bufwack
Lindsay Farrell
Kathy Grant-Davis
Bruce Gray
Ricardo Guzman
Stephanie Harrison
Paloma Hernandez
Sherry Hirota
Craig Hostetler
Kevin Kearns
Walter Keeley
Annette Kowal
Lolita Lopez
Toni McGuire
Ben Money
Louise Reese
Cheri Rinehart
Bobbi Ryder
Susan Wilson