The performance of an fqhc and its impact on the public s health
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"The Performance of an FQHC and Its Impact on the Public's Health". PALOMA HERNANDEZ Planning Committee State Hospital Review and Planning Council JUNE 18, 2010. Overview - Urban Health Plan. Founded in 1974 by Dr. Richard Izquierdo Became FQHC in 1999

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The performance of an fqhc and its impact on the public s health

"The Performance of an FQHC and Its Impact on the Public's Health"

PALOMA HERNANDEZ

Planning Committee

State Hospital Review and Planning Council

JUNE 18, 2010


Overview urban health plan

Overview - Urban Health Plan

  • Founded in 1974 by Dr. Richard Izquierdo

  • Became FQHC in 1999

  • 4 practice sites in the South Bronx and Queens

  • 5 School Sites 4 Off Sites

  • 2 Administrative Sites

  • Fully implemented EHR System since 2006

  • Largest Employer in our Zip Code: 480

  • 2007 National Exemplary Award, US EPA

  • 2009 Selected as one of the top performing Health Centers in the US by HRSA

  • 2009 Nicholas E. Davies Award by HIMSS

  • 2009 PCMH Level 3 Certification

  • 2009 Actual Volume: 231,000

    Users: 38,000

  • 2010 Volume Projections: 260,000

    Projected Users: 45,000


Community profile south bronx source nycdohmh community health profiles 2005 per 100 000

Community Profile – South BronxSource: NYCDOHMH Community Health Profiles 2005* per 100,000


The performance of an fqhc and its impact on the public s health

Community Profile – 16th Congressional DistrictSource: US Census Bureau 2006-2008 American Community Survey 3-Year Estimates

  • 59 percent of people 25 years and over have at least graduated from high school and 10 percent had a bachelor's degree or higher.

  • 41 percent were dropouts; they were not enrolled in school and had not graduated from high school.

  • The median income of households was $23,270.

  • 19 percent of the households received Social Security. The average income from Social Security was $10,116.

  • 40 percent of people live in poverty.

  • 53 percent of children under 18 live in poverty.

  • 37 percent of people 65 years old and over live in poverty.


Urban health plan s performance

URBAN HEALTH PLAN’S PERFORMANCE


Percent of patients ages 18 with smoking history documented source nycdohmh pcip

Percent of Patients Ages 18+ with Smoking History DocumentedSource: NYCDOHMH PCIP


Percent of patients ages 18 screened for alcohol use source nycdohmh pcip

Percent of Patients ages 18+ screened for Alcohol UseSource: NYCDOHMH PCIP


Percent of patients ages 18 with a documented bmi within the past 24 months

Percent of Patients Ages 18+ with a Documented BMI within the past 24 months


Childhood obesity source nycdohmh

CHILDHOOD OBESITYSource: NYCDOHMH


Percent of patients ages 18 with sexual history documented source nycdohmh pcip

Percent of Patients Ages 18+ with Sexual History DocumentedSource: NYCDOHMH PCIP


Percent of sexually active patients ages 16 26 tested for chlamydia source nycdohmh pcip

Percent of Sexually Active Patients Ages 16-26 tested for ChlamydiaSource: NYCDOHMH PCIP


Percent of patients ages 50 with an influenza vaccine

Percent of Patients Ages 50+ with an Influenza Vaccine


Percent of patients ages 18 screened for depression source nycdohmh pcip

Percent of Patients Ages 18+ Screened for DepressionSource: NYCDOHMH PCIP


The performance of an fqhc and its impact on the public s health

Percent of CSD Patients with a 50% Reduction in PHQ ScoreSource: HRSA Health Disparities Reporting Website


The performance of an fqhc and its impact on the public s health

Percent of Depression Patients with a 6 month ReassessmentSource: HRSA Health Disparities Reporting Website


Percent of diabetic patients ages 18 75 with a documented a1c source nycdohmh pcip

Percent of Diabetic Patients Ages 18-75 with a Documented A1cSource: NYCDOHMH PCIP


Percent of diabetic patients ages 40 on statins source hrsa health disparities reporting website

Percent of Diabetic Patients Ages 40 + on StatinsSource: HRSA Health Disparities Reporting Website


Percent of diabetic patients 40 on aspirin source hrsa health disparities reporting website

Percent of Diabetic Patients 40+ on AspirinSource: HRSA Health Disparities Reporting Website


Uhp asthma registry size

UHP Asthma Registry Size


Average symptom free days out of last 14

Average Symptom Free Days (out of last 14)


The performance of an fqhc and its impact on the public s health

Percent of Asthma Patients with a Severity AssessmentSource: HRSA Health Disparities Reporting Website


The performance of an fqhc and its impact on the public s health

Percent of Persistent Patients on Anti-Inflammatory MedicationSource: HRSA Health Disparities Reporting Website


The performance of an fqhc and its impact on the public s health

Percent of Asthmatic Patients with a Documented Self Management GoalSource: HRSA Health Disparities Reporting Website


The performance of an fqhc and its impact on the public s health

Hunts Point/Mott Haven Comparison of Asthma Hospitalization Rates in Children Aged 0-14, 1997 to 2005Source: NYCDOHMH

58% Decrease

HP 2010 goal

2.25/1,000

1997

2005


The performance of an fqhc and its impact on the public s health

Hunts Point-Mott Haven NYCComparison of Asthma Emergency Room Visits 2003 to 2008

Source: NYCDOHMH PCIP

55% Decrease

2003

2008


Business case affinity health plan pmpm comparative data of uhp v all affinity network 2006 2007

Business CaseAffinity Health Plan PMPM Comparative Dataof UHP v. All Affinity Network 2006-2007


Geriatric comparative outcomes

Geriatric Comparative Outcomes


Percent of patients with an influenza vaccine

Percent of Patients with an Influenza Vaccine


Percent of geriatric patients with a physical in the past 18 months

Percent of Geriatric Patients with a Physical in the past 18 months


Percent of geriatric patients with a pneumoccal vaccine

Percent of Geriatric Patients with a Pneumoccal Vaccine


Percent of geriatric female patients with a mammogram within the past 2 years

Percent of Geriatric Female Patients with a Mammogram within the past 2 years


Urban health plan s health care delivery system

URBAN HEALTH PLAN’S HEALTH CARE DELIVERY SYSTEM

  • Culture of Performance Management and Improvement

    • Supported by a Learning Center for Professional Development

    • Supported by Use of Data

  • Fully implemented Electronic Health Record System

    - Supported by a Provider Incentive Program

  • Care Coordination

    - Supported by Health Education and Care Managers

  • Innovative Programs

    - Project HOPE

    - Health and Wellness Program in collaboration with the

    Canyon Ranch Institute


Potential impact on emergency room growth

Potential Impact on Emergency Room Growth

  • Realistic goal of increasing FQHCs in NYS …..remembering that a DTC is not an FQHC

  • Upgraded Diagnostic and Treatment Center

  • Utilize FQHCs HPSA scores to open sites near ERs

  • Mandate linkages between ERs and FQHCs (RWJ –Urgent Matters Project)

  • Encourage change in Reimbursement Models so that we are properly compensated for the level of service that we provide


Contact information

CONTACT INFORMATION

Paloma Hernandez

Urban Health Plan

1065 Southern Boulevard

Bronx, New York 10459

(718) 991-4833

[email protected]


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