Ohio Community Health Centers

1
Ohio Community Health Centers

• Presentation for
• The Ohio Healthcare Coverage Reform
• Advisory Committee
• Presented by
• Shawn Frick
• December 11, 2007

2
Ohio Association of Community Health Centers
(OACHC)

• Professional trade association representing all
  34 of Ohios Federally Qualified Health Center
  (FQHC) and Look-Alike (FQHCLA) networks
• Healthcare home and family doctor for more than
  340,000 Ohioans annually
• Providing high-quality, affordable, primary and
  preventive health care and care management
  services regardless of insurance status or
  ability to pay
• 140 locations, including 3 mobile units in 44 of
  Ohios 88 counties

3
What is a Community Health Center (CHC)?

• A non-profit, community-based provider of
  high-quality, affordable primary care and
  preventative services regardless of insurance
  status or ability to pay
• Improve access to care in medically underserved
  communities often providing dental,
  pharmaceutical, and behavioral health services
  on-site

4
Five Characteristics of a CHC

• Must serve a high-needs area (MUA/MUP)
• Comprehensive healthcare and related services
  based on the needs of the community
• Open to all community residents, regardless of
  insurance status or ability to pay
• Governed by the community (51 board members must
  be patients)
• Held to strict accountability and performance
  measures for clinical, financial and
  administrative operations by HRSA (Health
  Resources and Services Administration)

5
What Services Are Provided?(All services
required either on-site or under arrangement)

• Behavioral Health
• Transportation
• Case Management
• Pharmacy
• After Hours Care
• Hospital/Specialty Care

• Primary Health Care Services
• Primary Care - All Ages
• Basic Lab
• Emergency Care
• Radiological Services
• Dental Screening for Children
• Preventive Health Dental

6
Are CHCs Cost-Effective?

• Of the 120 programs rated by the federal Office
  of Management Budget, CHCs were one of only 12
  programs that received an effective rating this
  year
• Considered the best program within the U.S.
  Department of Health and Human Services.
  (www.expectmore.gov)
• CHC patients have lower admissions and shorter
  stays in hospitals (GW, 1999)
• CHCs reduce ER use (13-38 fewer visits for
  health center patients) (Harvard)
• 18 billion nationally -- almost 1 billion in
  Ohio -- wasted on non-emergency care in ERs
  (NACHC)

7
Compared to Medicaid Patients Treated Elsewhere,
CHC Medicaid Patients

• Are between 11 and 22 less likely to be
  hospitalized for avoidable conditions
• Are 19 less likely to use the ER for avoidable
  conditions
• Have lower hospital admission rate, lower lengths
  of hospital stays, less costly admissions, and
  lower outpatient and other care costs
• Saving 30-33 in total costs
• per Medicaid beneficiary

Sources Falik et al. Comparative Effectiveness
of Health Centers as Regular Source of Care.
2006 Journal of Ambulatory Care Management
29(1)24-35. Falik et al. Ambulatory Care
Sensitive Hospitalizations and ER Visits
Experiences of Medicaid Patients Using FQHC.
2001 Medical Care 39(6)551-56. Duggar BC, et
al. Health Services Utilizations and Costs to
Medicaid of AFDC Recipients in CA Served and Not
Served by CHCs. Center for Health Policy
Studies, 1994. Duggar BC, et al. Utilization
and Costs to Medicaid of AFDC Recipients in NY
Served and Not Served by CHC. Center for Health
Policy Studies, 1994.
8
Do CHCs Effectively Manage Chronic Illness?

• The Health Disparities Collaborative (HDC) is a
  quality improvement program funded through
  HRSA/BPHC.
• The goal of the HDC is to eliminate disparities
  in health outcomes for poor, minority, and
  medically underserved populations.
• The Institute of Medicine recognizes CHCs as
  models for screening, diagnosing, and managing
  chronic conditions
• Diabetes Depression
• Cardiovascular Disease Cancer
• Asthma HIV

9
The Healthcare Solution
Competitive Drug Pricing
Source Prices for Brand-Name Drugs Under
Selected Federal Programs, Congressional Budget
Office (June 2005) Pharmaceutical Discounts
Under Federal Law State Program Opportunity,
William H. von Oehsen (May 2001).
10
Where Are Ohios CHCs Located?
11
Ohio Demographics
340,320 Patients 1,228,250 Visits
Age
Race/Ethnicity
Information based on 2006 UDS data.
12
Ohio Demographics
Payment Source
340,320 Patients 1,228,250 Visits
Poverty Levels
Information based on 2006 UDS data.
13
Ohio CHCs serve

• 1 in 10 of the Uninsured
• Nearly 1 in 10 Medicaid recipients
• 1 in 5 people living in poverty
• Nearly 1 in 10 of Ohios minority population

14
Comparison 2002-2004-2006
15
Comparison 2002-2004-2006
16
Comparison 2002-2004-2006
Providers to include Medical, Dental, Mental
Health, and Substance Abuse staff
17
Comparison 2002-2006
18
Uninsured Patient Rates Climb
19
For additional information

• OACHC Staff Contact Info
• Shawn Frick, sfrick_at_ohiochc.org
• Julie DiRossi, jdirossi_at_ohiochc.org
• www.ohiochc.org