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Health Care Tour: “Seeking Patient-Centered Care”
New Horizon Family Health Services
The Issue:
- In a health care system that is costly, fragmented and hard to access for many, New Horizon Family Health Services (NHFHS), a private, non-profit Federally Qualified Health Center, provides patient-focused health care that is accessible and affordable.
Findings:
- New Horizon’s 140 employees serve 20k patients a year at 10 locations. Services include - primary medical care, preventative health services, social work, Medicaid eligibility assistance, patient education, specialty physician referral, dental health services referral, diabetic teaching, same day walk-in services, on-site pharmacy, on-call nursing, and nutrition care.
- Medicare and Medicaid patients comprise 50% of the clientele. New Horizon is a major provider for these patients in Greenville since fewer doctors accept Medicaid and Medicare patients.
- Three on-site pharmacies fill 120k prescriptions each year.
- Psychiatric and social care is provided by masters-level social workers who address mental health issues and work under a psychologist. Mental and physical health are often linked. 50% of chronic illness patients show symptoms of depression and anxiety.
- Funding - NHFHS operates on a $16 million budget.
- $6 million from Medicare & Medicaid, $3 million from federal grants and $7 million from patient payments.
- NHFHS accepts insurance. Eligible self-pay patients pay a sliding fee ($20 minimum) based on income and family size.
- Community Health Centers base prices on the cost, not reimbursement rates. NHFHS operates on a cost-based reimbursement.
- There is no funding for facilities, so fundraising is required for any growth or capital improvement. Bon Secours Saint Francis, United Way, and many other organizations and foundations provide these needed funds.
- Studies show the health center model for primary care is effective and efficient.
- NHFHS participated in a six-year study which produced a model for treating chronic diseases. The concepts were designed to improve the quality of health care to underserved populations. In the end, the model has become a new basic level of care for all populations.
- Chronic care programs can assist patients to self-manage their health conditions.
- The single most important concept for self-managing a chronic disease is goal-setting. Patients select a simple health goal each time they come in for a visit (making an appointment, adjustments in diet, reducing hemoglobin measurement, etc.).
- Hemoglobin measurements for New Horizon’s diabetic patients averaged 8.5. NHFHS set a goal of 7.0 and has exceeded that goal with a new average of 6.9.
- A South Carolina Budget and Control Board study compared treatment of Medicaid patients in Federally Qualified Health Centers (FQHCs) with patients attending family practice physicians who accepted Medicaid.
- The average cost for a patient in the FQHC system was $1,340 vs. $1,778 for those in family practice care (25% less).
- Savings were due to lower hospital, ER and drug costs. Patients of the federal clinics had a higher instance of chronic diseases, yet the cost of their care was less.
- The clinic model provides availability of all the needed medical personnel (pharmacist, dietician, diabetic specialist) at one site.
- Primary care provides a “health care home” that facilitates compliance.
- “It’s not that patients don’t want to [comply], but the medical system is often so fragmented and complicated and confusing. It is overwhelming for patients. Patients often qualify for services, but don’t know about them or where to turn to access services."
- Primary care emphasizes patient care instead of “sick care” and provides the basis for a cost-effective health system model.
When: March 18, 2008
Where: Mallard Street, Greenville, SC 29601
Host: Regina Cook (CEO), Stephanie Brundage, MD (CMO), Jennifer Clark (COO), Stephen Glenn (CFO), Sybil Farrow (Board Chair), Jimmy Batson (Board Member), Elaine Broderick (Board Member), Kathy Smith (Director Of Nursing), Kathy Grant (Director of Quality), Paula Williams (Exec. Asst), Charles (Chuck) Arnold, NP, Jana Morse, M.D., Steven Evans (Director of Marketing and Development), Catherine A. Warner (Health Policy Analyst, SC Primary Health Care Assoc)