1. Florida’s Primary Care Imperative Peter Shin George Washington University Department of Health Policy Geiger Gibson Program in Community Health Policy July 29, 2008

2. Primary Care Homes in Florida Growing uninsured population Decreasing primary care physician supply Increasing need for comprehensive care and care management Health reform without capacity improvements Patchwork infrastructure –Hospitals, rural clinics, health departments, free clinics, private practices, etc. –FQHC

3. Serving low-income and high risk communities, 2006 NOTE: 100-200%FPL rates are 22% for FQHCs and 20% for the state. SOURCE: GWU Department of Health Policy analysis of 2006 UDS data, HRSA; Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau''s March 2006 and 2007 Current Population Survey (CPS: Annual Social and Economic Supplements).

4. Targeting low-income minority populations, 2006 NOTE: FQHC nonwhite (25% Black and 40% Hispanic); Florida nonwhite (15% Black and 2% Hispanic) SOURCE: GWU Department of Health Policy analysis of 2006 UDS data, HRSA.; Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau''s March 2006 and 2007 Current Population Survey (CPS: Annual Social and Economic Supplements).

5. Caring for the uninsured, 2006 Source: Health center data from 2006 UDS, HRSA (patients). Population estiamtes from Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2006 and 2007 Current Population Survey (CPS: Annual Social and Economic Supplements).

6. Care for the poor is not poor SOURCE : The two composite estimates include diet and eating habits, smoking, and drinking and pap smear, mammography and breast exam from Politizer R,, et al. “Inequality in America: The Contribution of Health Centers in Reducing and Eliminating Disparities in Access to Care.” Medical Care Research and Review 2001; 58;234-248.

7. FQHCs cannot do it alone SOURCE: The Robert Graham Center and the National Association of Community Health Centers, Access Denied, 2007.

8. Imperative for Stronger Primary Care Safety Net Building on effective practices and partnerships Coverage ≠ access –Uninsured, underinsured, and uninsurable –Massachusetts Improving workforce Using data Stakeholders