Sacramento Region Health Care Partnership. Notes and Stakeholder Input

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1 Sacramento Region Health Care Partnership Notes and Stakeholder Input January 30, 2012 Compiled by The Abaris Group 1

2 Introduction At this convening on January 30, 2012, s team of consultants presented preliminary data on a market assessment for the Sacramento Region Health Care Partnership. The purpose of the convening was to present the initial findings on the market assessment and to receive input on the data received to date, as well as suggestions for future data analysis. Approximately 60 invited participants attended the January presentation to meet the consulting team, receive the preliminary data to date and to provide input and commentary. Convening Agenda 12 p.m. Registration and Lunch 1 p.m. Welcome Chet Hewitt, President and CEO Diane Littlefield, Vice President of Programs and Partnerships 1:15 p.m. Introduction of Team and Team Roles Abraham Daniels, Program Officer 1:20 p.m. Market Analysis The Abaris Group Public Health Institute 2:30 p.m. Break 2:40 p.m. Data Discussion/Strategic Planning Hatches Consulting 3:20 p.m. Next Steps Abraham Daniels 3:25 p.m. Closing Remarks Diane Littlefield 2

Approximately 60 invited participants attended the January presentation to meet the consulting team, receive the preliminary data to date and to provide input and commentary. Convening Agenda 12 p.m. Registration and Lunch 1 p.

3 Market Analysis The Abaris Group and Public Health Institute presented the preliminary market assessment baseline of the current service capacity within the primary care safety net and the forecast of community clinic capacity needs. The preliminary market assessment presentation is online at dated 01/30/12. Breakout Session Notes and Stakeholder Input Hatches Consulting, The Abaris Group and Public Health Institute facilitated a process for all attendees to provide feedback in small breakout groups to answer the following questions: (1) What are the additional data needs (2) What additional questions need to be answered (3) Other commentary regarding the study and reform in general Summary of Responses: (1) More individual data is needed by county (2) Update data as available (2011) (3) More details needed on: a. Mental health b. Substance abuse c. Homeless d. Dental (4) Interest in capacity assessments/projections (5) Specialty care access (6) Strategic partnerships and collaboratives in the region and leveraging or building them 3

Breakout Session Notes and Stakeholder Input Hatches Consulting, The Abaris Group and Public Health Institute facilitated a process for all attendees to provide feedback in small breakout groups to

4 Grouped Responses: Responses were grouped into three categories. Summary of Break out Session Held on January 30, 2012 (1) What are the additional data needs +/ Revenue service s break down 2011 data? Additional data needed health plan, hospital level, children and seniors. Acuity role for FQHC Better define ACA population Medi Cal, Exchange Consumer experience and expectations for future Drill down to county Zip Code data Forecast Homeless How specific is patient data zip code/demographics Language gaps LIHP data needs to be updated Map the need/current use Mental health More info on CHIS data validity Need income distribution for each county Need more information about Medicare pop, mental health and dental needs Residential care facilities Substance abuse & mental health data needed Need income distribution for each county Need more information about Medicare pop, mental health and dental needs Substance abuse & mental health data needed Trend chart services by county/clinic What are costs in ED for PCP visits vs. CAC visits What are the differences in access and quality of care between under/uninsured and commercial payers What is the cost of ED visit Need more data on dental, mental health and substance abuse issues 4

Acuity role for FQHC Better define ACA population Medi Cal, Exchange Consumer experience and expectations for future Drill down to county Zip Code data Forecast Homeless How specific is patient data

5 Summary of Break out Session Held on January 30, 2012 (2) What additional questions need to be answered Are people going to Sacramento for services Barriers Capacity = compared to what standard Capacity = how do we measure what we shoot for Capacity = how do we rank compared to them Capacity/research on health systems/private providers Does coverage mean access Effectiveness of access and costs to outcomes of delivery systems (need analysis) for CHCs and acute care systems H1 community How can clinics be ready/know about FQHC funding How do CHCs work with other community partners to improve access How do non FQHCs fit How do we meet needs How do we regionalize needs to best meet the community needs How many PCPs will see newly eligibles How will ACA really play out Increase onsite enrollment Mobile MD Need to incorporate info about non FQHC community clinics, confusing which is FQHC and which are CHCs Need to know true capacity physical, mental, dental Pilot health referral Reasoning behind the county population projections what are the drivers Resources for HIT funding/support/legal Slide 26 needs better explanation (county indigent enrollment data) Slide 86, what s the reason, what should be done (Additional assessments underway) So what? What do you see? What is happening? Specialty care What about improving partnerships What about specialty care What are older health providers transition plans What are the educ./literacy gaps, services, locations, ED use 5

costs to outcomes of delivery systems (need analysis) for CHCs and acute care systems H1 community How can clinics be ready/know about FQHC funding How do CHCs work with other community partners to

6 What are the reasons/barriers low income pops are not being served by clinics What are the resources/funding pictures over time What clinics provide the best quality, who are the most effective, who is providing the best cure for their patients What does low % of health professionals mean What happens to the undocumented population, what do we do about it What is Medi Cal scope of service What is provided now, future challenges What will happen to small businesses Where are the clinics in the FQHC process Where do preventative health services fit in Where do the community based providers fit in this Where does the next clinic go Why needed Will providers leave because of Medi Cal Summary of Break out Session Held on January 30, 2012 (3) Other commentary regarding the study and reform in general Best practices that can grow to scale Budget cuts/government resources Check whether data is accurate CHWs/promatoras undervalued unless PPS for FQHC Clinic Consortia Clinics aren t getting reimbursed Community benefits FQHC ability to allocate G & A for PPS rate means higher revenues than charitable CHCs Gaps in getting people enrolled Have services that will travel among counties Higher education council does it Hospital ED use implications, what to do How sensitive is data to economic context/recovery Incorporating substance abuse reimbursement at FQHCs Increase the number of providers contracted with 3rd party payers/gmcs 6

is provided now, future challenges What will happen to small businesses Where are the clinics in the FQHC process Where do preventative health services fit in Where do the community based providers

7 Level hospital bed cap Leverage existing community services Midtown now Look Alike Models T3 and Interim Care Program Need key messages so much info Need level playing field between CHC types Need to digest Non FQHCs (Planned Parenthood) get reimbursed fraction of FQHCs Placer & El Dorado were the healthiest, but they have the fewest clinics Possible legislative approach to make it easier Slide 22 update (impact of ACA in California) Slide 39 legend (possibly meant slide 38 CHCs by Zip Code??) Slow application process to get reimbursement approval for CHCs Some CHCs have EMRs, some do not. This impacts coordination & referral systems Stakeholder support for the entire system Transportation needs to move to the top of the list Uncertainty between now and 2014 Where will the resources come from Need level playing field for FQHCs and CHC Issues around increased demand Will there be additional funding Next Steps/Meeting Close: The next steps will be to schedule four county specific strategic planning meetings. The information gathered at these meetings will inform the regional strategic planning process. Abraham thanked everyone for their participation and valuable feedback and adjourned the meeting. The California Endowment and Sacramento Region Community Foundation are funding partners for the Sacramento Region Health Care Partnership s market analysis and strategic planning process. 7

22 update (impact of ACA in California) Slide 39 legend (possibly meant slide 38 CHCs by Zip Code??) Slow application process to get reimbursement approval for CHCs Some CHCs have EMRs, some do not.

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