2013 NACHC WINTER STRATEGY MEETING HEALTH CENTERS HEALTH CENTERS A SOLUTION OF CHOICE.
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Transcript of 2013 NACHC WINTER STRATEGY MEETING HEALTH CENTERS HEALTH CENTERS A SOLUTION OF CHOICE.
2013 NACHC WINTER STRATEGY MEETING
HEALTHCENTERSHEALTH
CENTERS
ASOLUTIONOFCHOICE
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.
2013 NACHC WINTER STRATEGY MEETING
HEALTH CENTER ASSETS AND VULNERABILITIES
ASSET• Expertise in serving
vulnerable populations -- services under one roof; staff with cultural/ linguistic competencies
• Relationship with patients/communities we serve - we know them best & can communicate with them
VULNERABILITY• Improve the patient
experience or lose patient loyalty
• Lack detailed outreach, enrollment, and navigation strategies
HEALTH CENTER ASSETS AND VULNERABILITIES
ASSET• Existing programs, e.g.,
NHSC, help retain and recruit providers
• Have the data to make the health center value proposition
• Largest primary care network (patients, providers, etc.) – a “precious” commodity
VULNERABILITY• Strong competition, including
inability to match salaries offered
• Not using the data we have to its full potential, e.g., comparative performance analysis
• 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
• PCMH, including experience with EHRs, chronic care management and service integration
• Consumer-based boards
• ETC.!
VULNERABILITY• Limited Medicaid partner-
ships; dependent on payment model that is bound to change
• Care coordination and behavioral health capacity need to be increased
• Consumer-based boards – without proper training, development, and communication, become a liability
• ETC.!
CROSS-CUTTING CONCERNS1. 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 CONCERNS5. 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 OPERATIONSFor 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
MARKETPLACEUltimately, 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
POLICYOur 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
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
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
Mark BryantMary BufwackLindsay FarrellKathy Grant-DavisBruce GrayRicardo GuzmanStephanie HarrisonPaloma HernandezSherry HirotaCraig Hostetler
Kevin KearnsWalter KeeleyAnnette KowalLolita LopezToni McGuireBen MoneyLouise ReeseCheri RinehartBobbi RyderSusan Wilson
2013 NACHC WINTER STRATEGY MEETING
Thank you, Group Leaders!