Primary Care Alternatives Update Cliff Smith, Ed Houck and Jorge Quinonez Co-Champions

Primary Care Alternatives Convene stakeholders to develop a comprehensive, community-based system of primary care alternatives to the Emergency Room, targeting areas of greatest need. (Key elements may include neighborhood centers/clinics, mobile units, 24/7 access, service for under/uninsured, and possible roles for retired physicians and major employers.) Develop a method for educating non-emergent patients to use the appropriate care settings.

Primary Care Alternatives Scorecard

Continued Rapid Expansion in 2014 437  Volunteer Specialty Physicians (+93) Over 2000 Free hours of care provided Over 1,300 patients helped since program began Total value of donated care - $6.7 million Project Dentists Care launched in last quarter of 2014

Granted Federally Qualified Health Center Look-Alike Status Clinics in Dunbar, North Fort Myers, and Cape Coral United Way 211 I&R Specialist deployed at each Clinic

40% Increase in patients (6,693) and office visits (16,064) in 2014 Estimated 36% emergency room diversion Estimated savings of $1.5 million Tremendous increase in patients having Medicaid, Medicare, and private insurance Future expansion plans into targeted communities Improved financial condition in order to prepare for service expansion

Opportunities for Improvement and Next Steps: Offering patients low-cost medications under 340b program Recruiting providers through the National Health Service Corp Enhancing patient access to nutrition counseling and healthy foods Expanding patient access to care at existing clinics Adding service sites in Cape Coral and other high need communities

95 Agencies provide services in the UW Houses United Way Houses 15th and 16th United Way Houses recently opened in Charleston Park and Page Park 95 Agencies provide services in the UW Houses Over 290,000 client visits in 2014 All UW Houses have Health and Wellness Programs HIV/AIDS testing, pregnancy testing, mobile mammogram, Navigator Services, health screenings, etc.

Utilizes United Way 211 to Connect children with developmental delays to the services they need. Healthy Start Leading outreach efforts Physician Champion is Developmental Behavioral Pediatrician Adrienne Tedeschi, M.D. Partners include Early Steps, Lee Memorial, Early Learning Coalition, School District, and Florida Diagnostic and Learning Resources System (FDLRS)

Health Care Navigators Effort spearheaded by Health Planning Council United Way and McGregor Clinic also have Navigators (11 in total) Navigators helped 1,356 consumers this enrollment period Over 41,000 people in Lee County enrolled in Marketplace (85%+) this cycle

Accomplishments Served 73,576 patients for 255,428 encounters Opened Estero Office with Adult Medicine, Pediatrics, Dental and Pharmacy services and Cape Coral Office with Adult Medicine . Served 8163 patients at these new locations for 20786 encounters Achieved AAAHC accreditation in September 2014 Level 3 PCMH certification through NCQA for 12 sites Chronic Disease Management Team educated 1073 patients with Metabolic Syndrome, 418 gestational diabetic encounters and 1122 children in the ongoing ‘Quest for Kids Health’ program Provided 2374 women with breast health education, 975 risk assessments and 908 procedures

Opportunities for Improvement Expand Care Management for our Patient Centered Medical Homes and our ACO. Offer expanded hours in more sites Achieve Level 3 PCMH certification for the remaining 4 sites Improve payer mix

Next Steps Complete the build out of the Cape Coral site to accommodate Adult Medicine, Pediatrics, Dental and Pharmacy with an estimated completion date of December 2015 Expand operations to offer services in July 2015 at the Heights Foundation Clinic

Discussion Questions for the co-champions? Anything to add regarding Primary Care Alternatives to the EDs? Thoughts for further improvements?