News from Community Clinic Voice

The verdict is still out on whether a patient-centered medical home really achieve measurable cost savings and higher-quality health care, according to experts at a recent Capitol Hill briefing sponsored by the Alliance for Health Reform, but they want to continue work on the concept.

Patient-centered medical homes are a model of primary care considered an ingredient in the transformation of the U.S. health care system. They are made up of teams of health care providers who coordinate care and are proactive in reaching out to patients.

Melinda Abrams of the Commonwealth Fund said the idea is attractive because so many Americans have problems finding a primary care doctor and find inefficient and uncoordinated care when they enter the health care system...

Democratic lawmakers are seeking to use California's higher-than-expected revenue to restore Denti-Cal benefits and expand state mental health programs, California Healthline reports. Several witnesses at a Senate budget subcommittee hearing last week pushed for the restoration of Denti-Cal benefits, but the panel did not hold a vote on the issue.

Recent state budgets have cut reimbursement rates for Medi-Cal physicians, eliminated services not required by the federal government and imposed copayments on beneficiaries. In addition, California has eliminated adult dental services for an estimated three million low-income Denti-Cal beneficiaries to help reduce the budget deficit.

In March, California Controller John Chiang (D) said that state tax revenue for the first eight months of the fiscal year outpaced preliminary estimates by $4.5 billion, in part because of higher-than-expected personal income taxes...

Springing from the recent White House Summit on health disparities, ONC researchers – along with partners at the HHS Office of Minority Health and ZeroDivide – published this report that focuses on the ability of Health IT to reduce these disparities. ONC chief Farzad Mostashari is quoted in the report as saying that 展e have the opportunity and possibility with health information technology to tackle some of the most difficult problems by making visible what is often invisible in healthcare.

The summit outlined priority agenda items in the areas of technology, education and outreach, research and policy. Read more.

AND SEE: CDC Releases First Periodic Health Disparities & Inequalities Report

On 5/2/13, the California Endowment, in partnership with the Community Health Center Capital Fund and NCB Capital Impact, announced Program-Related Investments totaling $11.15 million to help six community clinics in the state prepare for the full implementation of the Affordable Care Act.

The loans went to LifeLong Medical Care, Berkeley, Clinica Sierra Vista, Bakersfield, Kedren Community Health Center, Los Angeles, Community Health Centers of the Central Coast, Nipomo, El Sol Science and Arts Academy of Santa Ana, and St. John痴 Well Child and Family Center, Los Angeles

Program-Related Investments are a funding alternative for established nonprofits with a reliable revenue stream and a healthy financial position. Unlike grants, PRIs are financial investments that require repayment. The Endowment痴 PRIs are part of its impact investing portfolio in support of the foundation痴 10-year Building Healthy Communities plan...

The latest CPCA Weekly Update of 5/3/13 reports on:

Advocacy Update Call Wednesday, May 8 & every Weds at 11:00 am Call-in Number: 1-866-469-3239 / Participant Code: 56814021 See a summary of the May 1 call on the Protect the Health Safety Net coalition and Medi-Cal Expansion. Realignment, the Remaining Uninsured, and the Legal Permanent Residents.

CPCA Senate testimony in support of Full Restoration of All Adult Dental Benefits (increase of $166 million GF).

Medicare Payments Reduced Due to Sequestration

腹Medi-Cal Managed Care April 23rd Webinar Slides & Recording Now Available - CPCA strongly encourages all health centers that are part of the new Medi-Cal Managed Care expansion to listen to this webinar; also useful as a refresher.

腹Covered California 4/23 Board Meeting Summary

腹Health Network: Free International Case Management - Migrant Clinician Network痴 Health Network facilitatse the continuity of care for mobile patients...

The Oregon Health Insurance Experiment represents the first use of a randomized, controlled study design to evaluate the impact of expanding Medicaid. In 2008, the state of Oregon drew names by lottery for its Medicaid program for low income, uninsured adults, creating the opportunity for a randomized controlled evaluation of the effect of Medicaid.

Although randomized controlled trials are the gold standard in medical and scientific studies, they are rarely possible in health policy. The study represents a collaborative effort between researchers and the state of Oregon

In the May 2, 2013 New England Journal of Medicine, researchers report clinical care and outcomes. They found that Medicaid coverage lowered rates of depression and nearly eliminated catastrophic out of pocket medical expenditures...

Planning for National Health Center Week, August 11-17, 2013, has begun. This theme this year is Celebrating America痴 Health Centers: Transforming Health Care in Our Local Communities.

This year NACHC is working with Points of Light to promote a wonderful opportunity for health centers to recognize volunteers who are making an impact locally. The Daily Point of Light Award celebrates the power of the individual to spark change and improve the world and during National Health Center Week these awards will highlight the power volunteers have had for health centers and the communities they serve.

You can nominate someone for a Daily Point of Light Award in just three easy steps:

1) By May 31, 2013, visit the Daily Points of Light submission website and nominate a volunteer affiliated with your health center...

BPHC/HRSA has issued a PAL addressing alignment of EHB Change in Scope Module with Change in Scope Policy. The link to the PAL is below.

PAL 2013-03 http://bphc.hrsa.gov/policiesregulations/policies/pal201303.html

Following a breach of unsecured protected health information covered entities must provide notification of the breach to affected individuals, the Secretary, and, in certain circumstances, to the media. In addition, business associates must notify covered entities that a breach has occurred.

•Individual Covered entities must notify affected individuals following the discovery of a breach of unsecured protected health information. Covered entities must provide this individual notice in written form by first-class mail, or alternatively, by e-mail if the affected individual has agreed to receive such notices electronically. If the covered entity has insufficient or out-of-date contact information for 10 or more individuals, the covered entity must provide substitute individual notice by either posting the notice on the home page of its web site or by providing the notice in major print or broadcast media where the affected individuals likely reside...

Understanding Evidence is a new, interactive web resource developed by CDC's Division of Violence Prevention that supports public health practitioners in making evidence-informed decisions around violence prevention. The goal of evidence-based decision making is to bring a high standard of research evidence into the decision-making process while taking into account the contextual and experiential factors that influence decisions. This free, online resource offers practitioners and others working to prevent violence important knowledge and resources for using evidence in their decision-making processes. Learn more.

The Brookings Institute proposes a framework for health care reform that focuses on supporting person-centered care. With continued innovation toward more personalized care, this is the best way to improve care and health while also bending the curve of health care cost growth, they write.

As a result of fundamental breakthroughs in biomedical science, improvements in data systems and network capabilities, and continuing innovation in health care delivery, care is becoming increasingly individualized and prevention-oriented. The best treatment for a patient involves not just specific services covered under traditional approaches to health insurance financing, but also includes new technologies and new kinds of care and support at home and beyond traditional health care settings. These advances require health care providers to work with patients and their caregivers to target increasingly sophisticated treatments and to coordinate care effectively ways that works best for each patient...

HHS on 4/29/13 announced Lyfechannel as the winner of the healthfinder.gov Mobile App Challenge. The winning app, called myfamily, will help individuals manage their family’s health through customized prevention information for each family member.

The app, which focuses on the preventive care benefits and services covered by the Affordable Care Act, will empower individuals to take greater action to improve and maintain their family’s health. Users can find customized prevention information and tips for each member of their family, create personal health alerts, and keep track of medical check-ups and vaccinations. Research shows that patients who are better engaged in their own health care have better health outcomes and electronic tools can help them be better health consumers...

News on Disparities, Funding, Health Reform, HIT, Innovation, Prevention, QI, Workforce & More! See: http://tinyurl.com/brkoz8j

http://www.californiahealthline.org/articles/2013/4/30/report-us-could-save-1t-via-integrated-care-ending-feeforservice.aspx


love the idea but expect it will take more like 70 years just to get there without a major paradigm and perceptual shift

anthony
 

California has the second-highest percentage of Medicaid beneficiaries compared with the state's population and the lowest average Medicaid spending per enrollee of all the states, according to Health Care Spending in the 50 States and Select Counties, a report released last month by the National Center for Policy Analysis.

Two years ago, the state Legislature authorized a 10% reduction in Medi-Cal reimbursements; that cut awaits federal ruling on a lawsuit challenging the reduction. Meanwhile, two new bills -- AB 900, by Assembly member Luis Alejo (D-Salinas), and SB 640, by Sen. Ricardo Lara (D-Long Beach), -- aim to reduce the effect of Medi-Cal cuts. Read more on AB 900.

With enrollment going up and already-low reimbursements going down, California Healthline asked legislators, state officials and consumer advocates how policymakers should steer California's Medi-Cal course...

HHS Secretary Kathleen Sebelius on 4/29/13 announced a new program to help military veterans with health care experience or training, such as medics, pursue nursing careers. The program is designed to help veterans get bachelor痴 degrees in nursing by building on their unique skills and abilities.

Administered by HRSA, the VeteransBachelor of Science in Nursing Program will fund up to nine cooperative agreements, of up to $350,000 a year. Funding of $3 million is expected to be awarded by September 30, 2013.

Program funding will go to accredited schools of nursing to increase veteransenrollment in and completion of baccalaureate nursing programs, and to explore ways to award academic credit for prior military health care experience or training...

Electronic medical records (EMRs) offer many benefits, giving providers instant access to all the patient health information stored within their system, from lab results and prescriptions to medical history and progress notes, anytime and anywhere. Yet currently there is no widespread method to electronically send patient health information between EHRs from different EHR vendors or between unaffiliated provider systems so when information needs to be shared, the digital record is often printed and faxed. California HealthCare Foundation, in collaboration with Palomar Health District in San Diego County and Sujansky and Associates, is testing a better way.

The DIRECT protocol, an open source set of standards for the secure exchange of records between different EHR systems, allows physicians to share patient health information directly from their EHR through secure electronic messages, similar to email. Over the course of the next several months, participating hospitals and community medical practices in Palomar Health, the largest health care district in California, will use the DIRECT secure message protocol to exchange referral requests, consult notes, and discharge summaries among a verified group of providers...

The National Association of Community Health Centers commends the Border Security, Economic Opportunity, and Immigration Modernization Act of 2013 as a critical first step toward creating a streamlined pathway for legal citizenship for the millions of people currently seeking opportunity in this country.

The Act, introduced by a bipartisan group of Senators, also updates and streamlines the current immigration and visa system to adjust the number and type of visas available擁ncluding those for physicians and others in the health care workforce.

NACHC adds that America痴 Health Centers are keenly aware of the financial and public health costs of going without primary and preventive health care. Legislation that updates our immigration process could contribute to improving our nation痴 health and controlling rising health system costs by increasing access to health care coverage and cost-effective primary and preventive health care services. Read more.

4/29/13 Update: A majority of the U.S. Senate, a total of 54 Senators, signed the Stabenow-Wicker FY2014 Health Center support letter, NACHC reports. In the House, 193 U.S. Representatives (45% of the House) signed the Bilirakis-Pallone FY2014 Health Center support letter. Both of these totals were the highest of the past four years!..

A Means to Informing Health Care and Social Policies for the Chronically Ill

Social determinants of health are the conditions in which individuals are born, grow, live, work, and age. Increasingly, they are being recognized for their relationship to the soaring incidence of Type 2 diabetes in the US, as well as the opportunities they present for us to counter it, says an article from the Patient-Centered Primary Care Collaborative (PCPCC).

Many current Type 2 diabetes interventions focus on biologic and behavioral factors, such as symptoms, diet, and physical activity. However, it is equally important to address the influence of physical and social environments, which may include low income, employment insecurity, low educational attainment, and poor living conditions, on health outcomes.

The ACA offers an opportunity to improve data collection and policy development to more effectively identify populations at high risk for developing Type 2 diabetes and to proactively refer them to appropriate social support services that may ultimately support reduction of health disparities. Expanding the scope of this legislation to include data that incorporate social determinants would improve the ability of clinicians and health systems to engage and to treat patients with chronic conditions, such as Type 2 diabetes, while expanding policymakersability to conform to the legislation痴 intent of shaping efforts to reduce chronic conditions nationwide...