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Deizel Sarte, Chief Operations Offi cer June 24, 2015
ACA-PCMH-TBC and The Medical Assistant-Health
Coach Initiative
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Today’s Agenda
NCHS-The OrganizationACA: Affordable Care ActWhere NCHS Fits in This JourneyPCMH: Patient Centered Medical
HomeThe Medical Assistant Health Coach
Initiative
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NCHS-The OrganizationEstablished in 197111 Sites
MedicalDentalWHS
59,262 Patients16,194 New Patients in 2014242,233 VisitsAll Primary Care Clinics NCQA PCMH
Recognized at Level 3 since 2012
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Historical Perspective
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ACA
PPACA: Patient Protection and Affordable Care Act Signed into law: March 23, 2010
EXPANDED COVERAGE
Medi-Cal Expansion (Also known as Medicaid) Medi-Cal was expanded beginning January 2014. Medi-Cal became available to adults under 138% of the
federal poverty level who are citizens or legal California residents for 5 or more years. For example, under 2011 FPL levels, a single individual making less than $1252 per month, or a couple making less than $1,691 per month, would be eligible.
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NCHS At The ForefrontStrategic Planning Process
SWOT AnalysisInternal and External ScanBoard of Directors and the Executive TeamCommunicating the PlanImplementing the Plan
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Patient Centered Medical HomeWhat is PCMH?A PCMH facility is a health care setting that facilitates
partnerships between individual patients, and their personal clinicians, and when appropriate, the patient’s family.
Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.
There is a set of standards that describe clear and specific criteria, the program gives practices information about organizing care around patients, working in teams and coordinating and tracking care over time.
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Patient Centered Medical HomePCMH
Why PCMH?Health care quality and access are
suboptimal, especially for minority and low-income groups
Health care in the community is fragmentedPoor health outcomesIncreased costsPoor morale amongst primary care healthcare
professionalsSupports IHI’s Triple Aim
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Medical Assistant Health Partners Initiative
Received a grant from The California Endowment to establish a MA Health Coach Program Curriculum
A collaborative between UCSD, FHCSD, NCHS and San Diego Mesa College
Grant provided:Funding to create a Health Career Ladder
ProjectFunding to create a community health
workforce development partnership
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Medical Assistant Health Partners Initiative
Started in 2013First year: 2 cohortsSo far: 7 cohort16 sessions
Train the “Mentors”General Class81 Medical Assistants graduated
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Medical Assistant Health Partners Initiative
The Curriculum:8 week program with two 4 hour sessions
per week taught by core instructor groupCore instructor group comprised of RNs
and health educators with expertise in area of focus
Comprised of theoretical and clinical skills modules with focus on family medicine
Available for review http://ca-hwi.org/
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Medical Assistant GraduatesConsidered a promotionAble to trigger “orders” from the “Pre-Visit
Protocols”40 year old female: Screening mammograms50 year old: Colon cancer screening
Establish a care plan with patients through motivational interviewing, teach back method, etc
Provide health education from a structured program
Reach out to patients from a disease based registry for coordination and follow ups
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Loma Alta Implemented TBC Q4 2013 >> Q2 2014
75
80
85
90
95
100
Medical Core Experience Scores by Quarter
Q3 2013
Q4 2013
Q1 2014
Q2 2014
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Chronic Disease Management - Diabetes 2013 to 2015
2013 2014 201520.00%
22.00%
24.00%
26.00%
28.00%
30.00%
32.00%
34.00%
A1c Poor Control - Loma Alta
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Prevention Improvement Team Based Care Implemented in 2013 to Current
2013 2014 20150.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
40.00%
45.00%
50.00%
Colorectal Screening - Loma Alta
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Questions and Discussion
For details, please contact:
Lisa McGerald, NCHS Director of Nursing
Email: [email protected]