Partnering to succeed: how small health centers can improve care and thrive under value-based payment
- Author(s):
- Coleman, Katie, author Hsu, Clarissa, author Berthoud, Heidi, author Tobey, Rachel, author Houston, Kiely, author Maxwell, Jim, author Rojasova, Sofia, author Austin, Brian, author Wagner, Ed, author Hummel, Jeff, author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, Calif.] : California Health Care Foundation, March 2018
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Community Health Centers -- organization & administration Primary Health Care -- organization & administration Value-Based Purchasing Community-Institutional Relations Health Facility Merger Health Workforce Leadership Organizational Case Studies Organizational Culture Patient Care Team Patient Care Management Patient Participation Public-Private Sector Partnerships Quality of Health Care Social Determinants of Health State Government Humans California United States
- Genre(s):
- Technical Report
- Abstract:
- Since their inception in the 1960s, community health centers (CHCs) have provided access to care for millions of Americans, including some of the most vulnerable individuals and families. As the economic environment of CHCs has changed, most recently with the expansion of Medicaid under the Affordable Care Act (ACA), these institutions have had to adapt quickly. In California, CHCs serve more than 4 million people annually. Many CHCs in California and nationally are experimenting with strategies to improve and expand care, such as finding ways to integrate behavioral health, bolster team-based care, and proactively reach out to patients with unmet preventive or chronic care needs. In tandem, health centers are increasingly participating in value-based payment. These actions require considerable infrastructure, with many components necessary for both endeavors. All health centers struggle to put this infrastructure in place, but small health centers--defined for the purposes of this paper as having fewer than 10,000 patients or an annual budget of $10 million or less--face unique challenges in securing access to capital, building strong data capabilities, and negotiating favorable rates with vendors and contracts with health plans. To help clarify the way forward for small health centers, this paper presents a Model for Advancing High Performance (MAHP) (see Figure 1). Based on research and expert opinion, it describes the actions and infrastructure CHCs will need to thrive in this new environment and contribute to a sustainable primary care safety net that achieves the quintuple aim--better care, better health, lower costs, happier staff, and reduced health disparities. As Figure 1 shows, engaging in the actions required to achieve the quintuple aim necessitates supportive infrastructure in four major areas: people, care systems/ strategies, data, and a business model. Infrastructure elements such as meaningful patient engagement in care, well-defined patient panels, and the ability to create actionable data reports are important to support both care transformation and value-based payment. For small health centers that are not in a position to create extensive infrastructure on their own, partnerships and alliances can be critical. When done well, such collaborations can help health centers fulfill their missions by supporting and supplementing primary care activities to leverage resources and improve health.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (55 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101744374 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101744374