1 ELICA HEALTH CENTERS PRESENTATION SACRAMENTO MEDI-CAL - PDF document

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ELICA HEALTH CENTERS PRESENTATION SACRAMENTO MEDI-CAL MANAGED CARE ADVISORY COMMITTEE OCTOBER 28, 2019 1. How many Sac County Medi-Cal managed care enrollees are served by your FQHC? Managed Care Member Assignment now exceeds 40,000 members Elica has provided primary care medical integrated with behavioral health and comprehensive oral health services through 103,806 visit for 29,108 unduplicated patients so far in 2019. 2

2. What changes has your FQHC made to improve access to care? a. New Sites: i. 1276 Halyard Drive - new ii. 5708 Watt Avenue - new iii. 3234 Marysville Blvd. - new iv. HOW-2/HOW-3 Mobile Units - (Dental, Medical and BH services) v. San Juan & Twin Rivers School Districts vi. 5385 Franklin Blvd. - planned expansion 2020 vii. 4815 Watt Avenue - planned new 2020 viii. +6 other sites under study for 2020-21 b. New Strategies: i. Dental Services ii. Behavioral Health/MAT iii. 340B Pharmacy iv. Pathways v. Health Homes Program - Case Management Expansion vi. Wellspace Referral Agreement: OB-GYN/Adult Dental vii. Practice Transformation - Patient Access Initiative viii. Patient First - Workforce Development ix. Alternative Capital Financing - New Market Tax Credits c. Success based on data i. Increased Enrollees by 30% in 2019 ii. Increased Utilization by 50% over the past two years iii. Should double capacity over the next five years iv. School Based medical outreach efforts in two different schools districts: 1. 421 school age children received wellness exams including vaccines based on the new regulations. 2. 186 Elica NEW patients met their HEDIS measures in August, 2019. 3. 421 children attended 1st day of school FY 2019-2020. 3. What strategies is your FQHC employing to improve your quality metrics? a. What specifically are you doing? i. Business Intelligence - Developing data infrastructure to improve insights and drive improvement to patient care and business practice. ii. Practice Transformation - EHR Optimization iii. Patient First - Workforce Development iv. IHAs, AWVs, IPPEs v. Clinic days, (Well Women, diabetic) vi. Diabetic Retinopathy Screening, soon implementing diabetic education group visits 3

vii. PHASE Kaiser grant: Preventing Heart Attack and Stroke. viii. OCHIN: HRSA HCCN award to participate as a nonprofit health care innovation center designed to provide knowledge solutions that promote quality, affordable health care for all. b. Demonstrated Success? i. Increase in HRSA quality awards (five of eight categories) including only one of three health centers in the state to receive the health disparities recognition. ii. Earned managed care quality incentives have Increased each of the last two years. iii. Certified Patient Centered Medical Home (PCMH) under the new 2017 standards and guidelines. Expanding to all sites in 2020. 4. What challenges are you facing? [organize challenges below into these 2 categories] a. Access to Care i. Capital funding of new sites ii. State licensing & facilities requirements iii. Physician recruitment iv. Workforce development b. Quality i. Data issues - data integrity and data sharing in a timely fashion, no Health Information Exchange ii. Timely Access & Accuracy of Managed Care (HEDIS, IHA, etc) Reports from Plans/IPAs iii. After claims submission – example: HEDIS updated Reports delayed up to 90 days iv. Members Assignments change from one Plan or IPA to another, and it develops issue of outreach/continuity of care v. Patient non-compliance 4