Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD...
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Transcript of Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD...
![Page 1: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/1.jpg)
Analysis of the 2004 Survey of Safety Net
Providers
Christy H. Lemak, PhDAllyson G. Hall, PhDLilliana L. Bell, MHA
March 3, 2006
![Page 2: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/2.jpg)
Introduction• County Health Department Clinics and
Community Health Centers (CHC) are designed to meet the needs of the medically underserved
• Play integral role in serving the uninsured
![Page 3: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/3.jpg)
Objective• Assess the infrastructure and capacity of
the health care safety net in Florida
• Explore the capacity of Community Health Centers (CHCs) to organize into health plans.
![Page 4: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/4.jpg)
Methods• Survey instrument designed at FCMU• Sample included DOH and CHC who are
members of the Florida Association of Community Health Centers (FACHC)
• Survey items addressed:– organizational challenges– disease management programs– managed care technology– patient access and demographics– continuum of care
• Based on similar questionnaire from NY
![Page 5: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/5.jpg)
Organizational Challenges
• Obtaining specialty care for patients (87%)• Patient complexity – social and economic
issues (66%)• Financial issues (64%)• Overall, CHCs had less challenges than
DOHs• All central Florida respondents indicated
‘obtaining specialty care’
![Page 6: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/6.jpg)
Disease Management Programs• 43% of organizations operate a formal
disease mgmt. program• Diabetes (27%), asthma (12%), mental
health (5%)• More CHCs have programs than DOHs• More than 80% of CHCs have reminder
systems for providers to administer screenings, order tests, etc.
• Half of central Florida respondents have a program (only for diabetes)
![Page 7: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/7.jpg)
Patient Care Access Tools
• Computer Based Systems:– 94% of organizations use computer-based
systems for scheduling and verifying Medicaid eligibility
– 3% use computer-based systems for tracking ER visits
– < 2% use computer-based systems for profiling hospital admissions and ER use by PCPs
– CHCs have more comprehensive systems (100% use computers)
– All Central Florida respondents have systems in place
![Page 8: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/8.jpg)
Patient Care Access Tools
• Access– 72% of organizations accept walk-ins on
a limited basis (depending on capacity)– 19% always accept walk-ins– 3% never accept walk-ins– Average of 2,557 appt. slots per week– DOHs more likely to accept walk-ins– Half of central Florida respondents
accept walk-ins on a limited basis, and half always accept walk-ins
![Page 9: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/9.jpg)
Patient Care Access Tools
• Language
– 87% of organizations have patients who prefer language other than English during visits
– Spanish (57%),Haitian Creole (8%)
– Most frequently, a friend or staff member acts as informal interpreter
– 60% of organizations use provider who speaks patient’s language
– Also use AT&T language line and trained interpreters
![Page 10: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/10.jpg)
Services for the Uninsured
• Organizations with Network/Subcontractor
– 87% of organizations have contracts with MediPass
– 46% have contracts with a Medicaid HMO
– 16% have contracts with Medicare
– CHCs more likely to network and/or subcontract
– 75% of Central Florida respondents have contractual relationships with MediPass or a Medicaid HMO
![Page 11: Analysis of the 2004 Survey of Safety Net Providers Christy H. Lemak, PhD Allyson G. Hall, PhD Lilliana L. Bell, MHA March 3, 2006.](https://reader036.fdocuments.net/reader036/viewer/2022082612/56649f295503460f94c43314/html5/thumbnails/11.jpg)
Services for the Uninsured• Financial Arrangements and Services for
Uninsured Patients– 84% of organizations charge uninsured
patients on sliding scale– BUT, 55% provide services without
regard to payment of financial arrangements
– < 8% require a deposit paid before visit– Most orgs don’t subsidize services to
the uninsured
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Services for the Uninsured• Local Programs/Activities for Uninsured
– 88% of organizations site the health dept. clinic, the Free/Volunteer clinic, and the Community Mental Health Center as the programs which address the uninsured issue
– 38% of CHCs and 16% of DOHs indicate a local health plan or benefits plan for uninsured in their area
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Services for the Uninsured
• Primary Care Services– County Health Departments only– 90% provide on-site primary care – Average of 369 primary medical
encounters per week