Chapter
Health Centers and ACA Private Insurance Expansions
National Health Service Corps Providers
Health Center Appropriations and the Community Health Center Fund
Health Center Appropriations and the Budget Control Act
Health Center Funding and ACA Care Coordination Initiatives
Health Center Funding and State Funding Availability145
APPENDIX A. OTHER FEDERAL PROGRAMS THAT MAY PROVIDE PRIMARY CARE TO THE UNDERSERVED
School-Based Health Centers
Nurse-Managed Health Clinics
Community Mental Health Centers
Native Hawaiian Health Care
APPENDIX B. MEDICARE AND MEDICAID PAYMENTS AND BENEFICIARY COST SHARING FOR HEALTH CENTER SERVICES
Medicare Payments to Health Centers
Mental Health Service Payment Changes
Chapter 2 REPORT TO CONGRESS: EFFORTS TO EXPAND AND ACCELERATE HEALTH CENTER PROGRAM QUALITY IMPROVEMENT*
Congressional Report Mandate
Expanding and Accelerating Health Center Quality Improvement: HRSA Efforts and Results
Sustaining and Advancing Quality Improvement
Report Mandate and Purpose
The State of Health Center Quality Improvement
Sustaining and Advancing Health Center Quality
THE HEALTH CENTER MODEL OF QUALITY CARE2
How Do Health Centers Serve Their Patients?
Whom Do Health Centers Serve?
People without Health Insurance
People of All Races and Ethnicities
Health Care for the Homeless Program
Public Housing Primary Care Health Centers
How are Health Centers Supported?
HRSA EFFORTS TO EXPAND AND ACCELERATE HEALTH CENTER QUALITY IMPROVEMENT
I. Federal Quality Data Collection, Analysis, and Reporting Requirements
Tracking and Analyzing Quality Improvement: HRSA’s Uniform Health Center Performance Measures
Tailoring Performance Measures for the Health Care Safety Net
Monitoring Health Center Quality Performance and Minimizing Reporting Burden: Aligning HRSA Grant and Data Reporting Requirements
II. Identification of Effective Quality Improvement Models
Identifying Health Center Best Practices21
Addressing Care Coordination, Disease Management, and Multiple, Co-Occurring Conditions
Delivering Coordinated Care
Providing Patient-Centered Care
Improving Access and Targeting the Underserved
“Virtual” Health Center Expansion
Improving Access to Specialty Services
Enhancing the Use of Electronic Health Records to Improve Quality
HRSA Leadership in HIT Adoption and Implementation
III. Adopting and Adapting Effective Quality Improvement Models
The HRSA Health Disparities Collaboratives
Improving Patient Safety and Managing Multiple Conditions: The HRSA Patient Safety and Clinical Pharmacy Services Collaborative
Providing Individualized Quality Improvement Support on the Ground: HRSA’s Office of Regional Operations
Moving Quality Improvement Efforts Forward at the State Level: Primary Care Association Activities
IV. QUALITY IMPROVEMENT TECHNICAL ASSISTANCE AND RESOURCES
Technical Assistance for Quality Improvement: National and State-level Health Center Resources
Ensuring Continuous and Coordinated Care for Migrant and Seasonal Farmworkers: The Migrant Clinicians Network - Migrant Health Network
Ensuring High Quality Care for People Experiencing Homelessness: The Health Care for the Homeless Clinicians’ Network
Supporting Patient Safety and Clinical Risk Management: The Health Center Federal Tort Claims Act (FTCA) Medical Malpractice Program
Closing the Gap on Patient-Provider Communication: HRSA’s Unified Health Communication Web Based Training Program81
V. Evaluating Quality Improvement Interventions
Assessing the Health Center Patient Experience: The 2009 HRSA Patient Survey
Continuous Quality Improvement: Analyzing and Tracking Health Center Trends, Needs and Performance
Tailoring New Health Center Performance Measures Developing Additional Standard Clinical Metrics
VI. Sustaining Quality Improvement Interventions
Expanding and Strengthening Access to Health Center Care
Targeting and Reaching the Underserved
Expanding and Sustaining Access to Affordable and Timely Primary Care
Opening Health Center Doors in More Communities
Strengthening Health Center Capacity
Expanding Health Center Services
Overcoming Barriers by Enabling Access to Care
Sustaining and Reinforcing the Health Center Model: HRSA’s Performance Analysis and Recommendations (PAR) Review Tool
Assisting Health Center to Achieve National Quality Standards: The Health Center Program Accreditation Initiative
VII. Quality Improvement Partnerships
Partnering to Promote Health Centers as Patient Centered Medical Homes: The Safety Net Medical Home Initiative90
Collaborating to Reduce Disparities in Hispanic Elders’ Health: Community Partnerships for Evidence Based Solutions91
Reaching out to Reduce Childhood Obesity: The National We Can! Initiative92
Improving HIV Prevention and Interventions in Primary Care: Developing Effective Health Center Models
APPENDIX A: HEALTH CARE SAFETY NET ACT OF 2008 PUBLIC LAW 110-355
Chapter 3 QUALITY INCENTIVES FOR FEDERALLY QUALIFIED HEALTH CENTERS, RURAL HEALTH CLINICS AND FREE CLINICS: A REPORT TO CONGRESS*
Quality and Health Information Technology (HIT) Incentives
THE QUALITY ENVIRONMENT OF FQHCS, RHCS, AND FREE CLINICS
The HIT Environment of FQHCs, RHCs, and Free Clinics
A Comparison of the Three Types of Safety Net Primary Care Providers
Key Differences between FQHCs and RHCS
OVERVIEW OF MEDICARE, MEDICAID, AND CHIP PAYMENTS TO FQHCS AND RHCS
Types of Quality Criteria and Incentives
FEDERALLY QUALIFIED HEALTH CENTERS
Definition and Federal Requirements
Impact of FQHCs on Cost and Quality
Reimbursement Policies for FQHCS
Quality Initiatives in FQHCs
Origins of Today’s Quality Initiatives
Bureau Common Reporting Requirement
Clinical Outcome Measures by Life Cycle (1980s, pre-HEDIS)
Health Disparities Collaboratives (HDC) (1998-2008)
Current HRSA/BPHC Initiatives Regarding Quality Activities
Requirement for on-going Quality Improvement/ Quality Assurance Program
Annual Uniform Data System (UDS) Reporting with Clinical Measures
Performance Measures in Grant Applications
Federal Tort Claims Act (FTCA) Deeming
Health Information Technology (HIT)
Adoption of Electronic Health Records (EHR)
Health Center Controlled Networks (HCCNs)
Patient Registries and Clinical Data Warehouses
Quality Incentive Programs
Quality Incentives in Medicaid and Commercial Managed Care Plans
Medicare Physician Quality Reporting System (PQRS)
“Health Home” Demonstration Projects: Medicare, Medicaid, Multi-Payer
Meaningful Use of Certified EHR Technology
Ongoing Data Collection on Meaningful Use and PCMH Recognition
The Rural Health Clinic Services Act
Prior Research on Quality at RHCs
Quality Initiatives in RHCs
Health, Safety, and Quality
Quality Assessment and Performance Improvement Program
Quality Improvement Requirement
Adoption of Care Coordination and Case Management Practices
Use of Health Information Technology (HIT)
Quality Incentive Programs
Physician Quality Reporting System
Medicare Electronic Prescribing (eRx) Incentive Program
Medicare and Medicaid EHR Incentive Program
Federal Efforts to Help Promote Rural HIT and EHRs
Rural Health Information Technology Network Development Program (RHITNDP)
FCC/Rural Health Broadband
Patient Centered Medical Home Practice Certification
State Initiatives Promoting Medical Homes
State Initiatives Promoting Performance-Based Payment
State Initiatives Promoting HIT Adoption
RHC Challenges in HIT and Quality of Care Initiative Adoption
Health Care Reform Legislation
Comprehensive, Coordinated, and Community-Based Care
Profile of the Free Clinic Sector
Heterogeneity in the Free Clinic Sector
Organizational Characteristics and Operations
Profile of Free Clinic Patients173
Scope of Services and Cost
Quality Initiatives in Free Clinics
What Do We Know about Quality of Care in Free Clinics?
Quality Incentive Programs
Federal Tort Claims Act (FTCA) Program
Overview of the Federal Program
Current Status of Quality Improvement Activities among Free Clinics
Participation in Quality Improvement Activities
Incentives to Increase Participation in Quality Improvement Activities
FTCA Deemed Clinics Query
Health Information Technology (HIT) in Free Clinics
The Scope and Diversity of the Primary Care Clinics
Incentives for Quality and Hit
Current Knowledge About Quality and HIT Performance in These Clinics
Health Reform and the Safety Net Clinics
Chapter 4 HOSPITAL EMERGENCY DEPARTMENTS: HEALTH CENTER STRATEGIES THAT MAY HELP REDUCE THEIR USE*
HRSA’s Health Center Program
HEALTH CENTERS HAVE IMPLEMENTED THREE TYPES OF STRATEGIES THAT MAY HELP REDUCE EMERGENCY DEPARTMENT USE
Federal Health Centers: Improving Care for the Medically Underserved
( Health Care Issues, Costs and Access )
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