"The Performance of an FQHC and Its Impact on the Public's Health" PALOMA HERNANDEZ Planning Committee State Hospital Review and Planning Council JUNE 18, 2010

Overview - Urban Health Plan Founded in 1974 by Dr. Richard Izquierdo Became FQHC in practice sites in the South Bronx and Queens 5 School Sites 4 Off Sites 2 Administrative Sites Fully implemented EHR System since 2006 Largest Employer in our Zip Code: National Exemplary Award, US EPA 2009 Selected as one of the top performing Health Centers in the US by HRSA 2009 Nicholas E. Davies Award by HIMSS 2009 PCMH Level 3 Certification 2009 Actual Volume: 231,000 Users: 38, Volume Projections: 260,000 Projected Users: 45,000

Community Profile – South Bronx Source: NYCDOHMH Community Health Profiles 2005 * per 100,000 MORBIDITY/MORTALITY HUNTS POINT/ MOTT HAVEN BRONXNYC Diabetes – (% of Adults)17% 12%9% Obesity – (% of Adults)25% 20% Asthma - (5 of Adults) 9%7%5% Child Asthma Hospitalization* 12%10%7% Heart Disease Hospitalization* 2,7732,2011,856 Death Rate Due to HIV* People Living w/ HIV/AIDS*3,1492, Hospitalization Mental Illness* Teenage Mothers, Year*

Community Profile – 16 th Congressional District Source: US Census Bureau American Community Survey 3-Year Estimates 59 percent of people 25 years and over have at least graduated from high school and 10 percent had a bachelor's degree or higher. 41 percent were dropouts; they were not enrolled in school and had not graduated from high school. The median income of households was $23, percent of the households received Social Security. The average income from Social Security was $10, percent of people live in poverty. 53 percent of children under 18 live in poverty. 37 percent of people 65 years old and over live in poverty.

URBAN HEALTH PLAN’S PERFORMANCE

Percent of Patients Ages 18+ with Smoking History Documented Source: NYCDOHMH PCIP

Percent of Patients ages 18+ screened for Alcohol Use Source: NYCDOHMH PCIP

Percent of Patients Ages 18+ with a Documented BMI within the past 24 months

CHILDHOOD OBESITY Source: NYCDOHMH New York City South Bronx Dr. Ally 3 to 4 y/o Underweight5% 4% Healthy Weight53%49%64% Overweight15%16%6% Obese27%31%26% Total percentage Overweight/Obese42%47%32%

Percent of Patients Ages 18+ with Sexual History Documented Source: NYCDOHMH PCIP

Percent of Sexually Active Patients Ages tested for Chlamydia Source: NYCDOHMH PCIP

Percent of Patients Ages 50+ with an Influenza Vaccine

Percent of Patients Ages 18+ Screened for Depression Source: NYCDOHMH PCIP

Percent of CSD Patients with a 50% Reduction in PHQ Score Source: HRSA Health Disparities Reporting Website

Percent of Depression Patients with a 6 month Reassessment Source: HRSA Health Disparities Reporting Website

Percent of Diabetic Patients Ages with a Documented A1c Source: NYCDOHMH PCIP

Percent of Diabetic Patients Ages 40 + on Statins Source: HRSA Health Disparities Reporting Website

Percent of Diabetic Patients 40+ on Aspirin Source: HRSA Health Disparities Reporting Website

UHP Asthma Registry Size

Average Symptom Free Days (out of last 14)

Percent of Asthma Patients with a Severity Assessment Source: HRSA Health Disparities Reporting Website

Percent of Persistent Patients on Anti- Inflammatory Medication Source: HRSA Health Disparities Reporting Website

Percent of Asthmatic Patients with a Documented Self Management Goal Source: HRSA Health Disparities Reporting Website

Hunts Point/Mott Haven Comparison of Asthma Hospitalization Rates in Children Aged 0-14, 1997 to 2005 Source: NYCDOHMH % Decrease HP 2010 goal 2.25/1,000

Hunts Point-Mott Haven NYC Comparison of Asthma Emergency Room Visits 2003 to 2008 Source: NYCDOHMH PCIP % Decrease

Business Case Affinity Health Plan PMPM Comparative Data of UHP v. All Affinity Network Non-UHP Providers UHP Network % Difference Pediatrics $81.11$ % Adults $280.62$ %

Geriatric Comparative Outcomes

Percent of Patients with an Influenza Vaccine

Percent of Geriatric Patients with a Physical in the past 18 months

Percent of Geriatric Patients with a Pneumoccal Vaccine

Percent of Geriatric Female Patients with a Mammogram within the past 2 years

URBAN HEALTH PLAN’S HEALTH CARE DELIVERY SYSTEM Culture of Performance Management and Improvement –Supported by a Learning Center for Professional Development –Supported by Use of Data Fully implemented Electronic Health Record System - Supported by a Provider Incentive Program Care Coordination - Supported by Health Education and Care Managers Innovative Programs - Project HOPE - Health and Wellness Program in collaboration with the Canyon Ranch Institute

Potential Impact on Emergency Room Growth Realistic goal of increasing FQHCs in NYS …..remembering that a DTC is not an FQHC Upgraded Diagnostic and Treatment Center Utilize FQHCs HPSA scores to open sites near ERs Mandate linkages between ERs and FQHCs (RWJ – Urgent Matters Project) Encourage change in Reimbursement Models so that we are properly compensated for the level of service that we provide

CONTACT INFORMATION Paloma Hernandez Urban Health Plan 1065 Southern Boulevard Bronx, New York (718)