Neighbors Caring for Neighbors Clinic. Objectives 1. 2.

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Neighbors Caring for Neighbors Clinic Slide 2 Objectives 1. 2. Slide 3 NCNC General Information The Neighbors Caring for Neighbors Clinics are Nurse Practitioner run clinics providing needed medical care to low income persons who are without insurance. This model of a free clinic, in which the staff is hired, provides continuity of care for the patient enabling better health outcomes. Slide 4 The mission of the Neighbors Caring for Neighbors Clinic (NCN Clinic) is to provide primary health care services to persons who are of low income, without insurance or underinsured and reside in Macomb County. This is done with respect and loving embracing care for each person at each encounter. Neighbors Caring for Neighbors Clinic Slide 5 Background Opened February 4, 1998Opened February 4, 1998 through a 3 Year Emily George (Sisters of Mercy) Grant June 1998June 1998; Second site added in Romeo (Now Washington Township) through a 4 County Foundation Grant July 2000July 2000 operations fully funded by St. Josephs Mercy Hospital (Henry Ford Macomb Hospitals) Slide 6 Service Features Continuity of Care Eligibility: >Uninsured persons of all ages >Macomb County residents >Household income less than $30,000 3 Days per week Mt. Clemens 1 Day per week -- Washington 2 Days per week -- Warren Slide 7 Slide 8 Slide 9 Total patients served since the Clinics opened In 1998 Mt. Clemens 12,600 Active: about 1,860 Washington - 3,065 *************************************************************** Generally about 33 new patients per week ******************************************************** Total Visits: Mt. Clemens + Washington Twp. 2008 January to June: 2710 2009 January to June: 3338 STATISTICS Slide 10 Types of Services Types of Services In Collaboration with Assigned Medical Director Family and Adult Nurse Practitioners provide the following medical and nursing care: Management of acute and chronic medical problems Well person, employment and school physicals Education on diseases and healthy living Slide 11 Slide 12 Clinic Visits by Diagnoses 2006-2008 Slide 13 Slide 14 Outcomes From the Diabetic Project Outcomes From the Diabetic Project Changes in Hgb A1c % 96 Patients had two or more Hgb A1c tests done in 2008 showing an average drop of 1.4% 40 Patients (42%) lowered their A1c to less than 7% 47 Patients (49% lowered their A1c by 1% or more Slide 15 NCN Clinic Cost Savings Tool Piloted 2006-2007 Revised to meet Clinic Needs CY 2008 $892,880.00 Neighbors Caring for Neighbors Clinics for the Uninsured Slide 16 The Process of Cost Savings and Avoidance Measurement The Process of Cost Savings and Avoidance Measurement 1.NP completes Daily Sheet makes judgment re: CS/A 2.Daily Sheets entered into EXCEL spreadsheet quarterly 3.Data reviewed and reported for HFHS Community Pillar report card and to other interested Slide 17 NEIGHBORS CLINIC DAILY SHEET PT#__________ DATE:________ TIME IN_________ APT:________ ADD ON:_______ WALKIN:________ PROVIDER: Anne____ Denise______ Jean _____ Val___ Nadine____Suzanne:___ Dr Naughton____ Other_______ ER since last clinic visit? Yes____ NO____ TODAYS PROBLEMS IF NEW 1Dx______________________________ Category 2Dx______________________________ Category 3Dx______________________________ Category 4Dx______________________________ Category LEVEL: A_ B_ C_ REFERRED TO:____________________ _____ER AVOIDED ____HOSPITALIZATION AVOIDED OTHER DIAGNOSIS ADDRESSED TODAY *** CIRCLE PRIMARY DIAGNOSIS*** ACUTE ILLNESS ADDICTION CARDIOVASCULAR CHF DENTAL DERMATITIS DIABETES: 1 ST A1C_____ LAST_____ EMPLOYMENT PE ENDOCRINE 1 ST TSH____LAST___ ENT ENVIRON. ALLERGIES GU/GYN GI HEALTH MAINTENANCE HEMATOLOGY HEPATITIS: A__B__C__ HTN:1 ST __ _ ____STAGE_____ LAST_ ______STAGE_____ HYPERLIPIDEMIA MENTAL EMOTIONAL MUSCULOSKELETAL NEUROLOGICAL PVD OBESITY:1 st _____LAST______ OTHER RESPIRATORY: TX_________ SCHOOL PE STD TOBACCO ABUSE 1 ST _______ LAST_______ TRAUMA ED:_______________________ Slide 18 $892,880 Slide 19 Slide 20 Individual Diagnostic Group Worksheets Worksheets were created for each Primary Diagnosis. It is on these worksheets that individual cost savings outcome data will be inserted. Below is a sample view of the worksheet tabs at the bottom of the spreadsheet. Each tab represents a different primary diagnosis. In EXCEL, each TAB (summary, ADD, CAR, DEN) is a worksheet. Data is only entered on the worksheets, NOT the summary sheet. REPLACE Slide 21 Insert Tab Sheet - HTN Slide 22 Insert Tab Sheet - Diabetes Slide 23 Slide 24 Slide 25 Slide 26 Slide 27 Calculation of Cost Benefit -- NCNC Calculation of Cost Benefit -- NCNC CY 2008 Benefit: $1 Community Benefit Dollar to $2.5 Cost Avoidance to Community! Recruitment of Community Partners Reporting of Community Benefit contacts and dollarsReporting of Community Benefit contacts and dollars Justification of philanthropy and operation dollarsJustification of philanthropy and operation dollars Evidence of benefit of clinics to community and health systemsEvidence of benefit of clinics to community and health systems USES OF COST SAVINGS/AVOIDANCE DATA Slide 28 Hospital System of Choice Data Should be collected and shared! Demonstrates who (which system) clients view as their source of support Helpful to request support/ collaboration and partnerships for clinics Demonstrates where clients are likely to go for hospitalization Slide 29 Thank You! Questions?