Inventive Group Based Ways to deal with System and Arrangement Improvement Went for Lessening Abberations in Essential C.

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Imaginative Group Based Ways to deal with Project and Approach Advancement Went for Diminishing Variations in Essential Consideration Sam S. Shekar, M.D., M.P.H. Partner Head for Essential Social insurance and Colleague U.S. Top health spokesperson American General Wellbeing Affiliation (APHA)
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Creative Community-Based Approaches to Program and Policy Development Aimed at Reducing Disparities in Primary Care Sam S. Shekar, M.D., M.P.H. Partner Administrator for Primary Health Care and Assistant U.S. Top health spokesperson American Public Health Association (APHA) 131 st Annual Meeting and Exposition November 15 - 19, 2003

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Health focuses that get a government gift are called Federally Qualified Health Centers (FQHCs) HRSA gives elected award subsidizing to wellbeing focuses to convey essential and preventive consideration Authorized under 2002 Amendments of the Health Centers Consolidated Care Act of 1996, segment 330 of the Public Health Service Act Consolidated wellbeing focuses include: Community Health Centers Migrant Health Centers Health Care for the Homeless Programs Public Housing Primary Care Programs School-Based Health Centers FQHCs and Health Centers

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$6M yearly spending plan 50,000 experiences/year 14,000 patients/year Services: General essential consideration Preventive screenings Chronic ailment administration Enabling administrations Source: BPHC, 2002 Uniform Data System (UDS) 30 clinicians/clinical experts 10 empowering staff 40 managerial staff Typical Health Center

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12.8 % 4 and under – 14.3 5-12 years – 20.2 13-24 years – 45.6 25-64 years – 7.0 65 and over – Presidential Initiative Calendar Year (CY) 2002 11.3 Million served 44.7 Million patient experiences >3,400 administration destinations 88.1% underneath 200% destitution 38.9% uninsured 63.9% racial/ethnic minority Serve all ages Source: Uniform Data System, CY 02, June 2003

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Health Centers: Sources of Funding ( FY 2002 est) Source: BPHC, 2002 UDS

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Health Centers and Medicaid Relationship : - 1/3 of Health Center Patients - 1/3 of Health Center Total Revenue - 2/3 of Health Center Patient Revenue Result : Decreased Avoidable Hospitalizations – Health Center Medicaid patients are 22% more averse to be hospitalized for conceivably avoidable conditions than those getting care somewhere else. Falik et al. Therapeutic Care Vol. 39, No 6; 2001. Wellbeing Center Medicaid patients are 11% less inclined to be hospitalized for possibly avoidable conditions than those with a typical wellspring of consideration who got mind somewhere else. Mobile Care Sensitive Conditions (ACSC) II Study to be distributed. Lower Health Care Costs – Cost of treating Health Center Medicaid patients is 30-34% not as much as expense for those getting care somewhere else; 26-40% lower for Rx; 35% lower for diabetics; 20% lower for asthmatics. Place for Health Policy Studies. Last Report; November 1994.

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President’s Initiative to Expand Health Centers By 2006: 1,200 new or extended wellbeing focuses 6 million extra individuals

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Access to Care: Uninsured Health Center Patients Face Fewer Primary Care Access Barriers than Uninsured Overall Source: Carlson et al. Essential Care of Patients without Insurance by Community Health Centers (CHCs). Diary of Ambulatory Care Management (JACM). 2001. *p<.001

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HRSA Health Disparities Collaboratives A national push to enhance wellbeing results though restoratively underserved individuals • Couldn\'t care less Management Collaboratives Diabetes, Cancer, Cardiovascular, Asthma, Depression, HIV/AIDS • Prevention Collaboratives Diabetes Healthy weight, tobacco utilization, circulatory strain, cholesterol, vaccinations, lead screening, oral wellbeing • Finance Redesign Pilot • Perinatal Risk Management – Planned

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HRSA Health Disparities Collaboratives The Care Model incorporates six fundamental components for enhancing the consideration of individuals with unending disease: Patient self-administration Evidence based choice bolster Clinical data framework to screen clinical results Delivery framework intended for patient and family objectives Organization of social insurance for quality Community organizations

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Health Center Patients With Diabetes Are Twice As Likely To Have Their Glycohemoglobin Tested on Schedule 50 43% 40 30 20% Health Center Patients 20 National Norm 10 0 Source: MDS Associates, Evaluation of the adequacy and Impact of Community Health Centers, in light of the National Health Interview Survey, 1999

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Collaborative Success “With governmentally subsidized wellbeing focuses having completely grasped the (Health Disparities Collaborative) model…this has turned out to be seemingly the biggest, most critical human services quality change activity in the nation. It’s precisely what the human services framework needs at this time - a show that it is conceivable both to enhance mind drastically and even lessen social insurance costs.” Tracy Orleans, Ph.D., senior researcher at the Robert Wood Johnson Foundation Advances Online , Robert Wood Johnson Foundation Newsletter, October 2002

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Healthy Communities Access Program (HCAP) Newly Established Legislative Authorization (340 Public Health Service (PHS) Act New Direction Stronger Emphasis on Health Care for Underserved Strengthens Vertical Integration Improves Chronic Care Coordination Builds Information Technology Systems Assists Infrastructure Development Healthy Community Access Program – FY 2003 35 new HCAP groups in 20 states got grants in FY 2003 129 HCAP groups got proceeding with trusts. As of now, HRSA has a sum of 164 HCAP grantees in 43 states HCAP Partnerships

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Public Health Center Entities Public Health Center Entities Under area 330(l)(2)(A), the Secretary may designate up to 5% of its segment 330 dollars to open focuses or elements that don\'t freely meet administering board necessities. In 2002, 39 open substances presently got $41 million of group and vagrant wellbeing focus reserves. General Health Entity Examples Multnomah County Public Health Department – Portland, Oregon Will County Community Health Center – Joliet, Illinois City of Austin Primary Care Department – Austin, Texas Lexington-Fayette County Health Dept. – Lexington, Kentucky Denver Health and Hospitals – Denver, Colorado Palm Beach County Health Dept.

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