The Role of Community Healthcare Centers in Puerto Rico Alicia Suárez Fajardo, MA Executive Director Asociación de Salud Primaria de Puerto Rico,

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1 The Role of Community Healthcare Centers in Puerto Rico Alicia Suárez Fajardo, MA Executive Director Asociación de Salud Primaria de Puerto Rico, Inc. (ASPPR) March 10, 2016

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3 Population by Payer Medicare 28,343 8% 12% Uninsured 40,462 10% Medicaid 229,495 70% Privately Insured 32,436

4 Special Populations Agricultural Workers Public Housing Residents Homeless People

5 Triple Aim and a Focus on Prevention

6 Triple Aim Health Centers are Designed to Meet all Three Aims. Focus on prevention and population based health Focus on improving patient experience of care Shifting towards value-based payment models 6

7 Primary Care Generates Substantial Savings Across the Health System

8 Primary Care Generates Substantial Savings Across the Health System

9 U.S. Health SystemSavings

10 Making it Possible! HRSA has guided health centers in Puerto Rico. CHCs are implementing what ACA wants to see in the local system. Patient Centered Medical Home 16/20 grantees. Health Integration Model Behavioral and Physical: 1 patient = 1 record EHR Use 19/20 grantees. Submit Clinical Quality Indicators 100% of the grantees Quality Incentives Program In the US there are 1,278 grantees out of the top 50 centers; PR has 5 of these leaders, leaders in quality.

11 A Unique Health Center for Every Community Centers are an asset for Puerto Rico: Made to fit the needs of the particular community. All Health Centers are required to carry out a Needs Assessment that demonstrates and documents the needs of its target population, updating its service area regularly. We are updating continuously.

12 Zika Community Outreach The Washington Post Visit The Washington Post came recently to Puerto Rico and asked to interview CHCs. The reporter came for a reason. She wanted to visit a CHC to see prevention on action.

13 CHCs in Puerto Rico Doing Outreach and Prevention

14 CHCs in Puerto Rico Doing Outreach and Prevention

15 HHS.GOV In a recent press release, the Health Secretary of the US, which is the regulator, presented the immediate needs of the healthcare system in PR. She mentioned the 20 Puerto Rico grantees as a key resource.

16 HRSA s Invests in Federally Qualified Health Centers

17 Primary Care HRSA Invests For Proper Perspective: Mi Salud Spends approximately $220 million in Primary Care. HRSA Health Center Program In 2014, HRSA invests $55.7 million in Community Health Centers. An estimate of 20% of primary care for the medically indigent. An estimated 1% of the total health care spending in Puerto Rico.

18 Our Responsibilities Significant Oversight HRSA 19 Program Requirements Site visit every three years Office of Inspector General Office of Management & Budget (OMB) Super Circular Clinical Quality Measures/Outcomes Fiscal Measures/Outcomes Sliding Fee

19 Our benefits Benefits Loan Repayment Program Primary Care medical, dental and mental/behavioral health clinicians can get up to $50,000 to repay their health profession student loans in exchange for a two-year commitment. Federal Torts Claim Act Federal government liability insurance. 340B Drug Discount These benefits are highly regulated by the federal government.

20 News from ASES Mi Salud Beneficiaries 1.7 millions 1.5 millions Reduction of 11.3% of participants Mi Salud Costs (per patient) $737 $1,762 A cost increase of 139% ASES doesn t present any quality data or evidence of healthcare outcomes. Source: Se disparan los costos por cada asegurado en Mi Salud (documento), Noticel, March 7, 2016, by Oscar J. Serrano.

21 Annual Savings in CHCs Source: The Economic Impact of Puerto Rico s Community Health Centers, Capital Link, 2014.

22 Top Employer in Many Municipalities CHCs employ over 2,700 employees. CHCs generate more than 2,400 indirect jobs for a total of more than 5,200 jobs. Economic Impact: It means more than $600 millions invested in our communities. Source: The Economic Impact of Puerto Rico s Community Health Centers, Capital Link, 2014.

23 Opportunities for the Future

24 Our Ecosystem HRSA has financed the modernization of CHCs in PR. The infrastructure of the CHCs has been remodeled and it s easily available for every patient.

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29 George Washington University Study CHCs serve 1 in 10 patients in PR. (of these, CHCs serve 1 in 7 of Mi Salud patients.).. health centers in Puerto Rico are best understood in terms of the patients they serve, the sources of revenues that sustain them, and their performance as a central means by which medically underserved communities and populations gain access to comprehensive primary health care and a point of entry into the health care system. As a group, health centers in PR out-perform health centers on a nationwide basis. Source: Puerto Rico s Community Health Centers in a Time of Crisis, December 14, 2015 (Peter Shin, Jessica Sharac, Marie Nin Luis, Sara Rosenbaum, RCHN Community Health Foundation).

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