Category Archives: Patient-centered care
Community Health Centers serve more than 22 million people at more than 9,000 sites located throughout all 50 states and U.S. territories, and have become needed health centers in particular for people newly insured under the Affordable Care Act (ACA) who have not previously had relationships with healthcare providers.
The National Association of Community Health Centers (NACHC) was organized in 1971 and works with a network of state health center and primary care organizations to serve health centers in several ways, including to:
- Provide research-based advocacy for health centers and their clients.
- Educate the public about the mission and value of health centers.
- Train and provide technical assistance to health center staff and boards.
- Develop alliances with private partners and key stakeholders to foster the delivery of primary health care services to communities in need.
Ronald A. Yee, MD, became chief medical officer of the NACHC last year. NewPublicHealth recently spoke with Yee about the mission of health centers and their new roles under the Affordable Care Act.
NewPublicHealth: What field of medicine did you practice before taking on your new role?
Ronald A. Yee: I am a family physician. I worked for 20 years at a community migrant health center in Fresno County. I basically practiced full-scope family medicine including obstetrics, so I was delivering babies up until October of last year when I came to NACHC. So I was on the frontlines doing patient care and I was also the chief medical officer for our health center. I got involved earlier in my career with NACHC on a state and then national level, was on the board and then became chief medical officer.
NPH: Who is most likely to use the services of a community health center?
Yee: Health centers provide about one quarter of all the primary care visits for low-income populations, which include about one in seven people who are uninsured, or one out of every 15 Americans. With the roll out of the Affordable Care Act we’re seeing a big surge in demand among the newly insured, whether that’s through Medicaid expansions or the health insurance exchanges. Many of our patients who previously paid on a sliding scale basis are now covered through the ACA, which is helping us extend the funding we have.
Caring for the millions of people acquiring health coverage under the Affordable Care Act will require many more primary care providers than are currently available. At a session today on New Models and Workforce Innovations for Primary Care Access at the 2014 National Health Policy Conference convened by AcademyHealth, presenters talked about emerging specialists for primary care, including nurses, physician assistants and care coordinators, who are also known as community health workers.
Pharmacists are also included in that provider model. Jeffrey Kang, MD, MPH, senior vice president of health and wellness at Walgreens, presented data on a model program the pharmacy chain has at more than a dozen hospitals which is helping reduce hospital readmissions. Walgreens has pharmacies at dozens of hospitals across the United States and with its pilot program, called WellTransitions, works with hospital discharge staff on medicine instructions and then follows up with phone calls once patients are home.
Kang said a key question is whether someone is taking the right medicine. In the medication orders system there is no procedure, other than patient initiative, for stopping a previously prescribed medication. For example, if a patient had been taking a blood pressure medication before a hospital stay and then is prescribed a new one in the hospital, they may still have vials of the drug at home, and studies show they commonly continue taking the drug, either instead of, or in addition to the drug prescribed during the recent hospital stay.
With the WellTransitions program, drugs are delivered to the patient before discharge, avoiding a trip to the pharmacy, and pharmacists follow up at 9 days and 25 days.
Walgreens launched the program in 2012 and released data late last year that showed that early results indicate that within the first 6 months that WellTransitions was operational in five hospitals, the 30-day readmission rate for patients in the program was 9.4 percent, compared with 14.3 percent for patients not participating in the program.