Community Health Centers

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Community Health Centers of Arkansas, Inc.
Community Health Centers
_______ ______ ___ __________
Community Health Centers of Arkansas,
Inc. (Arkansas Primary Care Association) Vicki
Jane Carver Quality Improvement Director
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Promoting HIT Adoption in the HRSA Community
Success through Collaboration

• Understanding Medicare HIT Policy
• November 5, 2007
• Arlington, VA
• 
  Community Health Centers of Arkansas

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CHCA

• Vision
• Where every Arkansan has equal access to
  affordable quality healthcare
• Mission
• To develop and protect the resources that ensure
  quality healthcare for all

Community Health Centers of Arkansas
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Community Health Centers Arkansas Locations

• 12 Federally Qualified Health Centers
• 55 Health Center Locations today
• 120,767 Arkansans
• 45.4 were uninsured
• (2006 UDS Data)

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Arkansas FQHCs

• Boston Mountain Rural Health Center, Inc.
• CABUN Rural health Services, Inc.
• Community Clinic at St. Francis House, Inc.
• Corning Area Healthcare, Inc.
• East Arkansas Family Health Center, Inc.
• Healthy Connections, Inc.

Community Health Centers of Arkansas
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Arkansas FQHCs

• Jefferson Comprehensive Care System, Inc.
• Lee County Cooperative Clinic, Inc.
• Mainline Health Systems, Inc.
• Mid-Delta Health Systems, Inc.
• River Valley Primary Care Services, Inc.
• White River Rural Health Center, Inc.
• Community Health Centers of Arkansas

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CHCs Patient Payor Mix
Medicare
Uninsured
Medicaid
Private Pay Private Insurance
Arkansas 2006 UDS
Community Health Centers of Arkansas
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CHCA Processes

• Develop Trust, Credibility, and Respect
• Provide Technical Assistance
• Coordinate Education / Training Drills
• Facilitate The Sharing of Best Practices
• Facilitate Mentoring
• Facilitate CHCA Networks
• Providers
• Nurses
• CFOs
• Purchasers
• Outreach Enrollment Workers

Community Health Centers of Arkansas
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Arkansas Quality Improvement Organization

• Arkansas Foundation for Medical Care (AFMC)
• CHCA has partnered with the Arkansas QIO
• Several of our FQHCs have received assistance
• 3 FQHCs have been actively participated in
• DOQ-IT Project
• White River Rural Health Center, Inc.
• CABUN Rural Health Services, Inc.
• Mainline Health Systems, Inc.
• Community Health Centers of Arkansas

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Doctors Office Quality Information Technology
DOQ-IT

• In Arkansas, there have been 3 different FQHCs
  that have participated in the DOQ-IT Project
• White River Rural Health Center, Inc.
• CABUN Rural Health Services, Inc.
• Mainline Health Systems, Inc.
• Began participation in 2004
• Community
  Health Centers of Arkansas

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Arkansas Health Information Technology

• Regional Quality Improvement
• Health Information Exchange
• Security/Privacy/Barriers/Implementation
• Quality Management
• Metrics Performance Measures
• Business Associate Agreements
• Payors Contract Limitations With Providers
• Health Education Materials
• Medicare Pay for Performance
• FCC Tele-health
• Community Health Centers of Arkansas

Community Health Centers of Arkansas
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Arkansas Regional Quality Initiative

• Multi-Stateholder Collaboration
• Unify Performance Measurement Methods
• Share Data for Greater Accuracy
• Common Metrics
• Discuss Incentive Opportunities
• Explore Models of HIE
• Research, Design Business Plan for Statewide
  Implementation
• Draft legislation for formal pursuit of AR HIE

Community Health Centers of Arkansas
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Arkansas Regional Quality Initiative

• Arkansas has chosen 4 HEIDIS Measures and
• will collect data from claims submitted to Payors
• Comprehensive Diabetes Care
• Eye Exams
• Lipids
• HbA1c
• Cervical Cancer Screening
• Adult Access To Preventive/Ambulatory Health
  Services
• Well Child Visits (3-6 years)
• Community Health Centers of Arkansas

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Arkansas Regional Quality Initiative

• Multi-Stateholder Collaboration
• Unify Performance Measurement Methods
• Share Data for Greater Accuracy
• Common Metrics
• Discuss Incentive Opportunities
• Explore Models of HIE
• Research, Design Business Plan for Statewide
  Implementation
• Draft legislation for formal pursuit of AR HIE

Community Health Centers of Arkansas
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Arkansas Regional Quality Initiative

• Multi-Stateholder Collaboration
• Unify Performance Measurement Methods
• Share Data for Greater Accuracy
• Common Metrics
• Discuss Incentive Opportunities
• Explore Models of HIE
• Research, Design Business Plan for Statewide
  Implementation
• Draft legislation for formal pursuit of AR HIE

Community Health Centers of Arkansas
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Arkansas Medicare P4P

• Arkansas QIO Selected to Implement DOQ-IT
• QIO Surveyed Family Practices for Readiness
• Family Practices determined ready to
  participate must request to participate in P4P
• Limited providers may participate in P4P
• Medicare Panel must be at least 50 Patients
• 1st year-1000 per physician 5000 per provider
  site
• 2nd and 3rd year-62,000 per practice
• 2nd year-FP must implement electronic health
  record

Community Health Centers of Arkansas
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DOQ-IT

• Unfortunately, our Community Health Centers have
  not been able to participate in the
  Pay-for-Performance with CMS
• Form 1500 is required by CMS
• CHCs utilize a 3 party fiscal intermediaries
  and file on the UB 92 now UB 04 Forms which are
  not allowed in the P4P aspect of DOQ-IT
• Community Health Centers of Arkansas

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• A network of interoperable systems linking
  clinical, public health and personal health
  information that providers could easily access
  to more effectively diagnose, treat and manage
  quality care.

Community Health Centers of Arkansas
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Health Information Technology

• HIT is a tool for measuring and improving health
  care quality
• Key to effective quality and performance
  improvement is easy access to clinical,
  financial, and operational information
• HIT is a continuum of electronically-enabled
  quality and management improvement efforts,
  including
• Practice Management
• Patient Registries
• EHRs

Community Health Centers of Arkansas
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HISPC

• Business Policies and State Laws as they pertain
  to privacy and security of patient
  informationbuild a National Health Information
  Network per RTI international and the National
  Governors Association
• Variation Workgroup
• Legal Work Group
• Implementation Work Group

Community Health Centers of Arkansas
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Tele-Video

• Continuing Medical Education
• Network Meetings-Sharing of Best Practices
• Consultation With Specialist
• Viewing Procedures/Practices
• Specialty Care Services
• Community Health Centers of
  Arkansas

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PCAs Role in Pay 4 Performance

• Develop relationships with Medicaid, 3rd Party
  Payors, QIO
• Position to be at the table when planning for
  P4P
• Research and provide information about Practice
  Management and EHRs to CHCs
• Provide Collaborative data and measures to P4P
  Planning Group
• Report to NACHC any and all plans your state is
  contemplating for P4P and the infrastructure

Community Health Centers of Arkansas
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Challenges / Barriers

• Technology
• Many of the Community Health Centers have limited
  access to computers / internet
• There are substantial challenges especially for
  the rural community health centers
• Some CHCs still have only dial-up or wireless
• NO broadband connectivity
• Community Health Centers
  of Arkansas

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Challenges / Barriers

• Data Reporting
• Difficult and Laborious
• Financial Resources Funding for Health
  Information Technology (HIT)
• Limited funds are available
• High initial investment
• Cost savings long term
• Community Health Centers of
  Arkansas

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Solutions

• Continuously researching for possible funding
  opportunities PCA will write and submit grants
• FCC Grant, if funded, would assist in providing
  Broadband Connectivity to rural Arkansas
• CHCs are moving forward with readiness
  assessments attending demonstrations from EHR
  vendors planning for the HIT future
• Engaged in Health Information Exchange (HIE)
  Initiative in Arkansas
• Community Health Centers of Arkansas

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Solutions

• Information Technology (IT) is an enabler
• Quality Healthcare Improvement / Outcomes
• Efficient
• Cost savings
• Continue to strengthen our partnership with AFMC
• Serve on Advisory Committees
• Continue participation in the Health Information
  Exchange (HIE) Initiative
• 
  
• 
  Community
  Health Centers of Arkansas

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Contact Information

• Victoria Jane Carver LPTN, BS,MPA
• Quality Improvement Director
• Community Health Centers of Arkansas
• [phone] office
• [phone] fax
• [phone] cell
• vcarver_at_chc-ar.org

Community Health Centers of Arkansas