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Community Health Visioning 2017
Primary Care Alternatives Lalai S. Hamric President/CEO Family Health Centers of Southwest Florida, Inc.
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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.
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Status Report: Key Accomplishments
Establishment of the Dunbar United Way House… Opening of the East Fort Myers United Way House… Renewal of Lee We Care as the Volunteer Health Care Connections specialty referral program serving patients living below poverty level… Establishment of a pediatric Healthy Living and Weight Management Clinic utilizing fixed sites and a regional Ronald McDonald mobile van… Regional expansion of the CenteringPregnancy pre-natal care program… Launch of Area Health Education Centers smoking cessation program… Institution of new emergency room patient follow-up referral process… Doubling of breast and cervical cancer screenings for uninsured low-income women under the Healthy Body-Healthy Soul Program… Offering of pre-school dental exams and annual school physicals… Launch of three First Choice Pediatrics offices in Lee County.
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Status Report: Barriers/Challenges
Current provider shortages, particularly for adult medicine, as a function of a physician “unfriendly” professional environment… Rapid growth of the number of uninsured people in Lee 30%+ Rising level of uncompensated care given by primary care providers in Lee County (e.g.-LMHS = $68 million/FHC = $14.2 million)… Uncertainty of revenue sources to pay for uninsured patient care (e.g.- Low Income Pool, DSH, Medicare reimbursement, etc.)… Lack of adult medicine specialists to provide care for working uninsured patients earning income just above the poverty level… Lack of a regional electronic health records “network” to promote medical homes and access to preventive medical care for all patients… Limited hours of primary care providers coupled with patient work schedule and transportation challenges.
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Status Report: Critical Success Factors
Establishing a local primary care “network” that maximizes the coordination and use of existing and future provider resources… Development of a regional health information system that improves patient care and health outcomes through improved sharing of clinical data among local care givers… Creation of the medical home concept that encourages all patients living in Lee County to have a local provider of primary, preventive and chronic disease care… Building a community consensus on how best to fund uninsured patient care via existing and proposed public and private revenue streams… Expansion of the specialist care network for uninsured patients… Recruitment and retention of primary care physicians and critical area specialty providers (e.g.- orthopedics, cardiology, oncology/chemotherapy, dermatology, gastroenterology, rheumatology, endocrinology, etc.).
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Status Report: Next Steps
Convene a local stakeholder task force to create a model community-based primary care system by pursuing… Achieve connectivity of existing electronic medical records systems utilized by local primary care providers… Creation of a medical home initiative to include examination of appropriate emergency room use by all patients… Study of how to finance care for the uninsured/working uninsured… Examination of local provider service networks that use a capitated fee approach to providing managed care that allows residual funds to be used for uninsured patient care… Expansion of existing neighborhood-based “clinics” to emphasize preventive medicine and chronic disease management programs… Development of a regional physician recruitment/retention strategy.
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Questions & Answers What are your top of mind reactions to what you have heard? Are there other accomplishments for this area you would like to share?
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