Health Care that revolves around you.

Transcription

1 Health Care that revolves around you.

2 MISSION STATEMENT Lone Star Circle of Care is committed to the pursuit of community-wide access to a behaviorally enhanced, patient-centered health care home that provides accountable care for all patients, focusing on the underserved.

3 OVERVIEW OF LSCC Community-wide access Currently 25 locations spanning three Central Texas counties Proud health care home to over 100,000 Central Texans Behaviorally enhanced Physical and behavioral health services are integrated within LSCC Accountable care for all patients Joint Commission-accredited NCQA, Level 3-Designated Patient Centered Medical Home Patient-centered health home Array of services to provide care patients need, when & where they want it Focusing on the underserved Access point primarily for uninsured & publicly insured individuals A non-profit, federally qualified health center network

4 HISTORY OF LSCC In its 10-year history, LSCC has grown from one small community clinic in Georgetown to one of the most robust and innovative federally qualified community health centers in the nation with 552 employees and a network of 25 clinic locations serving 100,000 people in Central Texas.

5 LSCC has been the fastest growing FQHCs in the nation for the last 2 years

6 2010 data from the National Association of Community Health Centers LSCC COMPARED TO FQHCs NATIONALLY (continued) Out of 1,128 health centers across the nation LSCC ranks: Number of Patients Number of Encounters/ Patient Visits Total Revenue It is anticipated that LSCC will be in the national top 25 in 2012 based on its growth Patient-Related Revenue Other Revenue (includes federal, state, & local grants

7 INCREASING ACCESS Patients Visits 470, , , , , , , ,000 70,000 20,000 (30,000) 24,895 35,348 10,489 15, , , , , ,121 96, ,481 74,224 73,215 82,712 54,865 24,336 33,051 40,429

8 HOW? DOES LSCC s HEALTH HOME MODEL WORK? Health Care that revolves around you.

9 LSCC S MODEL FQHC BENEFITS FUNDING SOURCES LSCC s MODEL 1. PPS rate HRSA Comprehensive 2. Safe Harbor 3. FTCA 4. Discount prescriptions PPS MNC Collaborative Coordinated IBH 5. Employ providers 6. HRSA grant opportunities PARTNERS PCMH MISSION Patient-Centered Benefits Partners

10 STRATEGY TO SERVE THE UNMET NEED Hospitals get primary care outlets and tax benefit. Providers get secure employment. COMMUNITY BENEFIT Uninsured and underinsured patients get access to quality care. LSCC realizes its mission. Without an annual, recurring federal grant to support each site, LSCC created sustainable expansion in two ways in order to reduce risk to our overall mission: With capital costs covered by the partner, multi-service sites (that include services to children and pregnant women who often have a funding source) would eventually break even or generate positive NOI due to payer mix Partners who wanted a clinic to be an alternative to Emergency Rooms and/or to focus on chronically ill patients (typically uninsured adults) agreed to cover the monthly expenses associated with operating this type of clinic By collaborating with hospitals, we avoided competing primary care strategies and instead partnered to increase sustainable access to care through a public/private partnership

11 SUMMARY OF STAKEHOLDER FUNDED SUCCESS Seton Healthcare Family (Ascension) St. David s HealthCare (HCA) & St. David s Foundation Round Rock Clinic (Family Practice) 6 Clinics at Texas A&M Health Science Center (Pediatrics, Adolescent, Family, Senior, OB/GYN, and Integrated Behavioral Health) 2 Sites in Hutto & Cedar Park (Pediatrics) Pending Austin Clinic (Family Practice, Pediatrics, OB/GYN, Integrated Behavioral Health) After Hours Call Line Education Round Rock Clinic (OB/GYN) Austin Clinic (ER Alternative) Senior Clinic (Georgetown) Integrated Behavioral Health Support Early HIT Support Scott & White Healthcare Belton Clinic (Pediatrics) Taylor Clinic (ER Alternative) Specialty Referral Network

12 WHEN? DO WE PROVIDE CARE? Connecting Patients (Members) to the Member Navigation Center Right Care, at the Right Place, at the Right Time. Focus on Prevention Increase Access Maintain Scheduled Check-ups

13 MEMBER NAVIGATION CENTER Proactively manages patients (members) using state-of-the-art technology, connecting them to every service they need throughout the continuum Responsive Patient- Centered Proactive Maximized via LSCC s EHR MNC staff can access data across LSCC s entire network versus a single clinic site Improves Quality Reduces Cost

14 Patient vs. Member Patient Definition A person who is under medical care or treatment A sufferer or victim Insinuates a reactive state in a specific scenario/situation (transactional relationship) Accounts for < 1% of our lifespan

15 Patient vs. Member Member Definition A person that is part of a society, party, community, and/or club Develop a sense of belonging, an active participant (affinity relationship) Accounts for >99% of our lifespan

16 Schedule appointments Lab results General questions Medication refills Triage Coordinate specialty referrals Chronic disease management Asthma Diabetes High Blood Pressure Follow-up reminders Health education

17 Percent of Patients HOSPITAL UTILIZATION Patients who have had a LSCC encounter were less likely to have an emergency department (ED) or inpatient hospitalization (IP) than those who had not Patients that have not had a visit to LSCC are nearly twice as likely to show up in the ED Patients that have not had a visit to LSCC are more than four times as likely to have at least one IP encounter If these 480 ED encounters were diverted to a LSCC facility, we would expect the cost savings for Superior to be approximately $357,284 per year Figure 1 - Emergency Department 1 and In-Patient 2 Utilization by LSCC Encounter Status % % 4.5% 5 1.1% 0 No LSCC Encounters LSCC Encounters No LSCC Encounters LSCC Encounters Emergency Department Utilization In-Patient Utilization Source: Integrated Care Collaboration (ICC), ICare 2.0 database. Prepared by: LSCC Analytics, JM, 9/26/2012

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