Presentation on theme: "Access to Care: Primary Care Challenges and Recommendations July 17, 2014."— Presentation transcript:
Access to Care: Primary Care Challenges and Recommendations July 17, 2014
Access to Care What is primary care? The Johns Hopkins Primary Care Policy Center defines primary care as: Entry point into a health services system for all new needs and problems Person-focused, not disease-oriented Provides care for all but very uncommon/unusual conditions Coordinates or integrates care – regardless of where, who provided Means to assure optimized care use and health status equity
Challenges? Deloitte Consulting study (2012): To meet pre-ACA implementation demand, Kentucky needs – 3,790 additional physicians (including primary care doctors and specialists) 612 more dentists 5,635 more registered nurses 296 more physician assistants 269 more optometrists Source: The Commonwealth of Kentucky Health Care Workforce Capacity Report http://healthbenefitexchange.ky.gov/Documents/KY%20Healthcare%20Workforce%20Capacity%20Report%20FINAL%205_28_13.pdf
Challenges? Kynect – the state health benefits exchange (as of 4/21/14) 413,410 Kentuckians enrolled in new health coverage, Medicaid and private 82,795 have purchased private insurance.
Challenges? UK’s Dr. Kevin Pearce, speaking to a meeting of Kentucky medical educators reported (5/13): 1500 : number of people that one full-time family physician should take care of 163 : number of family physicians that we need to add in Kentucky each year to meet 1500:1 by 2025 57 : maximum number of family physicians that could be produced per year in Ky now
Recommendations Doing Care Differently Physician-led teams coordinated, patient-centered, cost-effective quality care. How to get there? Expanded scope of practice for APRNs – what about PAs? Social worker can join primary care team; MD can offer primary care at CMHC Expanded role for dental hygienists – what about dental therapists? Peer specialists– in behavioral health – what about community health workers in primary care? Resources: Christensen and Hwang The Innovator’s Prescription Prevention Institute, Community-Centered Health Home
Recommendations Doing Care Differently Expanded use of telehealth and monitoring technology Better care integration – primary care, behavioral health, oral health A “health home” concept, starting with high-needs Medicaid patients/”superutilizers” An All-Payer Claims Database, where data on health care cost, use and quality cost effective care containment and quality improvement Kentucky Health Information Exchange (KHIE), connects providers’ electronic health records systems to state system for accessible patient clinical information
Infrastructure needed… IT path to care continuity: Retail clinics health homes hospitals rehab/home care Care coordination – at the patient and community level TA/Coaching for care providers (Ag Extension style) – credible resource to support/sustain care transformation: Whose role? AHECs Local Health Departments Regional Extension Centers Professional associations
Leverage opportunities State Innovation Model (SIM) grant – if awarded to bring cross- sector stakeholders to the table Aligning interests shared community solutions, payment strategies –Hospitals’ community benefit plans –Local health departments MAPPs –United Way community needs assessments MCO contract renewals contract terms supporting better integration, new care approaches Large employers (e.g., Kyiana Health Collaborative) new care and payment approaches, data sharing
Thank You!....Questions? Learn more at: www.healthy-ky.org Contact: Susan G. Zepeda, Ph.D., President/CEO 502-326-2583 email@example.com
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