Bureau of Primary Health Care Update
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1 Bureau of Primary Health Care Update 2014 National Health Care for the Homeless Conference May 28, 2014 Jim Macrae Associate Administrator Bureau of Primary Health Care Health Resources and Services Administration U.S. Department of Health and Human Services
2 Health Center Program Overview- Calendar Year Million Patients 93% Below 200% Poverty 36% Uninsured 62% Racial/Ethnic Minorities 1,121,037 Homeless Individuals 903,089 Farmworkers 219,220 Residents of Public Housing Health Center Revenue Sources ARRA Grants 2% Other Federal Grants 3% Health Centers Serve All Ages 25 to 64 51% 65 & up 7% Under 5 11% 5 to 12 13% 13 to 17 8% 18 to 24 10% BPHC Grants 18% State/Local/ Other 17% Self-Pay 6% Other 3rd Party 7% Medicare 5% Other Public Insurance 3% Medicaid 38% Source: Uniform Data System, 2012, Service Sites: HRSA Electronic Handbooks 1,198 Grantees with 8,900+ Service Sites 83.8 Million Patient Visits Over 148,000 Staff v 10,400 Physicians v 7,500 NPs, PA, & CNMs
3 Health Care for the Homeless Program Overview - Calendar Year 2012 Nearly 837,000 Patients 97% Below 200% Poverty 61% Uninsured 63% Racial/Ethnic Minorities 803,505 Homeless Individuals 14,648 Agricultural Workers 20,579 Veterans Health Centers Serve All Ages 65 & up 3% Under 5 5% 246 Grantees with 3,140+ Service Sites 4.4 Million Patient Visits Over 41,795 Staff v 4,086 Physicians v 2,073 NPs, PA, & CNMs 25 to 64 74% 5 to 12 4% 18 to 24 11% 13 to 17 3% Source: Uniform Data System, 2012, Service Sites: HRSA Electronic Handbooks
4 FY 2014 Funding and Spend Plan Awarded: $150 Million for 236 New Access Points Awarded: $58 Million in 1,157 one-time Outreach and Enrollment Grants to Health Centers Announced: $35 Million for PCMH Capital Awards Announced: $50 Million for Mental Health Service Expansion - Behavioral Health Integration Coming Soon: $110 Million in Base Adjustments Coming Soon: $300 Million for Expanded Services
5 Health Center Quality Awards PCMH Recognition Award Health centers recognized as PCMHs by July 1 st are eligible Annual award added to base adjustment for health centers that maintain PCMH recognition Quality Improvement Award Based on 2013 UDS submissions Four categories: Top Reporters reports on whole universe using EHR Top Improvers compared to self High Performers compared to peers using quartile rankings Clinical Excellence highest performers compared to national standards in key clinical areas
6 FY 2015 President s Budget $4.6 billion, including $3.6 billion from the Affordable Care Act Community Health Center Fund $100 million to fund 150 New Health Center Sites to serve an additional 900,000 Patients $860 million for one-time Quality Improvement and Capital Development awards Continuation of mandatory funding for health centers in FY2016, 2017, and 2018 at $2.7 billion annually
7 Affordable Care Act: Health Center Achievements & Updates As of March 31, 2014, health centers trained nearly 14,500 outreach and enrollment workers nationwide Health centers educated or assisted more than 4.7 million on affordable insurance options Keep sharing best practices and experiences with HRSA to share with CMS. 7
8 Affordable Care Act: Health Center Achievements & Updates In the last four years, ACA funding has: Established more than 550 health center new access points Expanded service capacity at more than 1,100 health centers Supported more than 1,700 quality improvement grants; targeting the development of patient-centered medical homes Awarded more than 130 expanded HIV treatment & care grants Funded outreach and enrollment activities in nearly 1,160 health centers and 50+ Primary Care Associations Supported more than 40 Health Center Controlled Networks Supported construction of 266 new service delivery sites and renovation of more than 400 health centers nationwide 8
9 Health Center Program Growth: National Impact Millions Patients Thousands Sites Thousands Jobs Growth from (% Increase) Patients 17,122,535 18,753,858 19,469,467 20,224,757 21,102,391 3,979,856 (23.2%) Sites 7,518 7,892 8,156 8,501 8,979 1,461 (19.4%) Jobs 113, , , , ,245 35,186 (31.1%) Source: Uniform Data System, and HRSA Electronic Handbooks
10 Health Care for the Homeless Growth Impact Thousands Patients Thousands Sites Thousands Jobs Growth from (% Increase) Patients 747, , , , ,980 89,263 (12%) Sites 2,531 2,639 2,761 2,921 3, (24%) Jobs 28,995 31,233 34,571 37,400 41,795 12,800 (44%) Source: Uniform Data System, and HRSA Electronic Handbooks
11 Homeless Patient Data Calendar Year HRSA supported health centers serve more than One Million homeless individuals and their families annually 1,200,000 1,000,000 Homeless Patients Served by Health Centers 1,018,084 1,051,750 1,087,431 1,121, , , , , , Source: Uniform Data System, 2012
12 Health Center Program Quality Strategy Better Care Healthy People & Communities Affordable Care INTEGRATED HEALTH SYSTEM INTEGRATED SERVICES COMPREHENSIVE SERVICES ACCESS Priorities & Goals 1. Implementation of QA/QI Systems Health Centers fully implement their QA/QI plans 2. Adoption and Meaningful Use of EHRs Health Centers implement EHRs across all sites & providers 3. Patient Centered Medical Home Recognition Health Centers receive PCMH recognition 4. Improving Clinical Outcomes Health Centers meet/exceed HP2020 goals on at least one UDS clinical measure 5. Workforce/Team-Based Care Health Centers are employers/providers of choice and support team-based care
13 Current Program Impact: Key National Indicators % of Health Centers with EHR Implementation (2012) 79% have EHRs at all sites used by all providers 11% have EHRs at some sites used by some providers % of Health Centers Achieving Patient-Centered Medical Home Recognition (as of March 2014) 73% of all health centers are participating in Patient-Centered Medical Health Home Initiatives (PCMHHI) and 44% have achieved Patient- Centered Medical Home (PCMH) recognition % of Health Center Meeting/Exceeding Healthy People 2020 Goals (2012): 59% Meet/Exceed Hypertension Control Goal of 61% 11% Meet/Exceed Diabetes Control (HbA1c 9) Goal of 84% 37% Meet/Exceed Early Entry into Prenatal Care Goal of 78% 61% Meet/Exceed Low Birthweight Goal of 7.8% Individual and State health center profiles with performance and compliance data are now available to the public on the HRSA web site. See: 13
14 Health Care for the Homeless Program Impact: Key Indicators % of Health Centers with EHR Implementation (2012) 92% have EHRs Installed. 83% have EHRs at all sites used by all providers. 17% have EHRs at some sites used by some providers. % of Health Centers Achieving Patient-Centered Medical Home Recognition (as of March 31, 2014) 69%% of all health centers are participating in Patient-Centered Medical Health Home Initiatives (PCMHHI) and 44% have achieved Patient-Centered Medical Home (PCMH) recognition % of Health Center Meeting/Exceeding Healthy People 2020 Goals (2012): 49% Meet/Exceed Hypertension Control Goal of 61% 5% Meet/Exceed Diabetes Control (HbA1c 9) Goal of 84% 25% Meet/Exceed Early Entry into Prenatal Care Goal of 78% 57% Meet/Exceed Low Birthweight Goal of 7.8% Individual and State health center profiles with performance and compliance data are now available to the public on the HRSA web site. See:
15 National PCMH Recognition FY
16 Health Care for the Homeless Program PCMH Recognition FY
17 Primary Health Care Our Focus Leadership Performance Improvement Program Requirements Organizational Excellence 17
18 Thank You! Questions? 18
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