Introduction to the Community Health Sector Tom Manning Primary Care - PowerPoint PPT Presentation

Introduction to the Community Health Sector Tom Manning Primary Care Development Corporation November 15, 2011

The Health Care Delivery Spectrum Ambulatory Hospital Long ‐ Term Specialty Acute Primary Emergency Home Nursing Ambulatory Inpatient Depts Care Care Homes Care Care Patient Flow

An Effective Community Health Sector Centered on Primary Care to produce: • Better Health • Lower Costs • Reduced health disparities between socio ‐ economic groups – akin to environmental justice

Use of the System Across the Spectrum Ambulatory Hospital Long ‐ Term Specialty Acute Primary Emergency Home Nursing Ambulatory Inpatient Depts Care Care Homes Care Care The “Well” The Acutely Ill Short Term Episodes The Chronically Ill

U.S. Far Outspends its Peers ‐ OECD Health Care Costs 1980 – 2006 Total expenditures on health Average spending on health as percent of GDP per capita ($US) 16 7000 Australia* Canada 14 6000 France Germany 12 Netherlands New Zealand 5000 Switzerland 10 United Kingdom United States 4000 8 3000 6 Australia* Canada France 2000 4 Germany Netherlands New Zealand 1000 2 Switzerland United Kingdom United States 0 0 1980 1984 1988 1992 1996 2000 2004 1980 1984 1988 1992 1996 2000 2004

Comparison of Average Cost of Care: Preventable (Ambulatory Care Sensitive) Conditions Community Health ER Visit Hospital Center Visit Non ‐ emergent Admission Non ‐ acute $140 $600 ‐ 1600 $9,000

The Health Care Paradigm is Changing Healthy Communities (Nutrition, prevention, physical fitness, healthy living, environment) Community Resources (Supportive housing, social services, eligibility programs, etc.) Medical Neighborhood (Specialists, ER, Inpatient, LTC + Behavioral Health) Medical Home (Primary Care)

What is Primary Care? The principal point of consultation for patients within a health care system, including all routine and preventive care plus initial consultations on new health conditions. Quality primary care is fully integrated into its community and will meet this definition: The provision of accessible health care services that are comprehensive, coordinated and continuous , by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community . (the Institute of Medicine)

Who Provides Primary Care in LICs? FQHCs • FQHC Look ‐ Alikes • Hospital Out ‐ Patient Departments (OPDs) & satellites • Hospital Emergency Rooms • Freestanding Clinics • Free Clinics • Rural Health Centers • Private doctors • In ‐ store clinics • Special Needs Providers: • Developmentally Disabled – Frail Elderly (Program of All ‐ inclusive Care for the Elderly, or PACE) – Substance Abuse / HIV+ / Homeless; including Homeless FQHCs –

Where is there opportunity? • FQHC expansion • Establishment of medical practices by Special Needs providers • Hospitals – reconfiguring care • Closing hospitals – saving the primary care • Health IT

Acknowledgements: Use along the health care spectrum – United Hospital Fund • OECD health costs – OECD data, compiled by The Commonwealth Fund • Costs of care, ACS conditions – National Assn. of Community Health Centers •

Contact: Tom Manning Managing Director, Capital Investment Primary Care Development Corporation TManning@pcdc.org 212 ‐ 437 ‐ 3920 www.pcdc.org Excellent Healthcare in Every Neighborhood Excellent Health in Every Neighborhood