2015 Services At A Glance Report
Transcription
2015 Services At A Glance Report
2015 Services “At A Glance” Our mission is to support and promote our patient’s total health with quality, integrity, respect, and compassion. To make a difference by serving the whole person – medical, dental, economic, social, psychological and spiritual. …Is it good for the patient? …Is it good for the staff? …Is it good for the organization? …Is it good for the community? Integrity: Sincerity, honesty and candor. (Doing the right thing) Respect: High or special regard for patients and each other. (Treating others as you want to be treated) Compassion: Giving, comforting and bringing hope. (“Being there” for others) Quality: High degree of excellence. Going above and beyond (Making a difference). MOTTO – “CAN DO” Customer Driven. Ahead of the Times. Innovative, continual learning and growing. No Margin – No Mission. Financial stability and growth. Dedication to HCCC mission and values. Open and honest communication. - People Growth/ Access - Quality - Finance - Service Be the Employer of Choice 2015 People Pillar Highlights 209 employees for year end 2015 60 staff hired in 2015 (replacements and new hires) Maintained competitive wage and benefit package Hosted Annual Party January 2015 Employee Appreciation recognition at April 2015 Staff Meeting Continued Reward and Retention staff bonus (.50 for every hour worked) Conducted Employee Stay Interviews throughout the year Distributed Employee Staff Survey December 2015 Offered and promoted Health Living Program for staff HCC continued support for Social Committee activities Renovated and updated work areas at Baker and Leahy sites • Executive Staff: (1 CEO, 1 CMO, 1 COO, 1 CFO, 1 CHRO) • Providers: • 5 Physicians (3 Family Practice, 1 Internal Medicine/PEDS, 1 Family Practice/OB) • 1 Fill-in Internal Medicine • 12 Physician Assistants (1 Pain Management) • 4 Certified Nurse Midwives • 11 Behavioral Health (1 LLP, 3 LMSW, 1 MA, LLP, 1 LLMSW, 1MA, LLPC) • 4 Maternal Infant Health Program (2 RN’s, 1 MSW, 1 BSW, 1 Dietician) • Dental: • 5 Dentists • 4 Dental Hygienists • Pharmacy: • 3 Pharmacists • 5 Pharmacy Technicians • Support: • 11 Clinical/Administrative Managers • 7 R.N. Care Managers • 136 Other Clinical/Administrative Support Staff Would you be proud to recommend Hackley Community Care as an employer? Staff Responses 2015: Staff Responses 2014: Staff Responses 2013: Yes No 154 (97%) 4 (3%) 127 (93%) 10 (7%) 132 (93%) 11 (8%) What a great experience for students and staff!!! 2015 2014 2013 3 2 6 Physician Assistants: Medical Assistants: R.N. Nursing Students: 16 Dental Assistant Students: U of M Dental Students: 19 MSU 3rd Year Medical Students 2 0 19 18 1 Grand Valley State University • Pre-Med Students 1 • Dietician Student 1 Clerical Students - THC 1 Frontier University CNM Students Admin/Clerical Students 3 1 2 TOTAL 25 25 45 HCC Healthy Living Program HCC staff are encouraged to lead a healthy lifestyle. HCC offers a Healthy Living incentive program; staff can choose to participate and earn “points” - $1 for each point (up to $100)! We have had great success with this program! 2015 2 Sessions… $8,711 Paid out to staff Match Services with Identified Community Needs 2015 Growth/Access Pillar Highlights Total patients 17,602 (2014 total patients 17,500) Received BPHC/HRSA two year Expanded Services Grant funding (2014-2015). Surpassed goal of reaching 672 new patients. Increased growth and access in School programs: Hub: (Muskegon Teen Health Center, Marquette, Nelson, Covenant, and Muskegon Heights Academy) Continued School Wellness Program at Muskegon Middle School Built Oakridge Teen Health Center, and began operations 12/2015. ^ Capital campaign Goal $504,000: raised $400,000 from private foundations, and major donors, Chef Prize fundraiser net profit $20,000 We hired one part-time Pediatric PA in early 2015, and lost a part-time Pediatrician at the end of 2015. We contracted for three new PA’s to start in January, 2016. We lost two Dentists (one full-time, and one part-time) at the end of 2015, and we are actively recruiting. CEO is Board member for MPCA, Michigan Community Health Network, Muskegon Rotary, United Way, and Pathfinders. Community Collaborations: Health West: Integrated Care Clinic partnership and collaboration regarding designation as a pilot Certified Community Behavioral Health Clinic CEO co-chaired 1 in 21 Healthy Muskegon County Initiative State Innovation Model (SIMS): CEO and CHO participating in model development for Muskegon Pilot project Continued work on Violence issues within Cities of Muskegon and Muskegon Heights – discussions with Pathfinders, Boys and Girls Club, Muskegon Heights Mayor and City Council, Police, and Community Continued work on Issues of Poverty - United Way focus on (ALICE) Asset Limited, Income Constrained, Employed CEO on Executive Committee for the Community Coordinating Council HCC Services: Preventative health care services - medical & dental Acute and chronic health care services - medical & dental Minor office surgeries OB services and Family Planning Maternal and Infant Health Program Behavioral Health and Substance Abuse School Based Services Laboratory services Nurse case management Pharmacy Spiritual Care Consultants Group Visits / Classes Chronic Disease Smoking Cessation Networking and support Total Patients: 2015 2014 2013 17,602 17,500 16,330 By Race / Ethnicity: African American 38% 38% 38% White 46% 48% 48% Hispanic 9% 9% 9% American Indian .5% .5% .5% Other / More than one race 6% 4.5% 4.5% 0-10 24% 24% 28% 11-18 18% 18% 20% 19-39 29% 29% 28% 40-64 25% 23% 22% 65+ 4% 4% 3% Female 58% 58% 58% Male 42% 42% 42% By Age: By Gender: New Patients Total: 2015 2014 2013 3,139 3,725 2,819 MEDICAL 2015 2014 2013 Medicaid 683 (39%) 778 (36%) 796 (50%) Medicaid HMP 409 (23%) 560 (26%) ----- ----- Medicare 45 (3%) 94 (4%) 109 (7%) Uninsured 429 (24%) 480 (22%) 549 (34%) Other 192 (11%) 245 (11%) 147 (9%) 1,758 (100%) 2,157 (100%) 1,601 (100%) Medical Total DENTAL 2015 2014 2013 Medicaid 981 (71%) 1197 (76%) 1,000 (82%) Medicaid HMP 320 (23%) 280 (18%) ----- ----- Uninsured 61 (4%) 65 (4%) 193 (16%) Other 19 (1%) 26 (2%) 25 (2%) 1,381 (100%) 1,568 (100%) 1,218 (100%) Dental Total Total Billable Visits: 2015 2014 2013 86,516 84,832 79,703 Billable Visits by Department: Medical 44,705 43,984 45,675 Dental 19,269 18,171 20,010 OB 5,257 4,601 3,974 Behavioral Health 5,738 6,290 5,794 Maternal Infant Health Program 2,385 2,774 2,400 School Based Programs 6,055 2,702 2,613 Integrated Health Clinic 1,504 1,181 761 Medicaid 73% 65% 66% Medicare 11% 8% 8% Commercial 8% 9% 7% Uninsured 8% 18% 19% Billable Visits by Payor: “GROWTH IS NEVER BY MERE CHANCE; IT IS THE RESULTS OF FORCES WORKING TOGETHER.” Improve Patient Outcomes 2015 Quality Pillar Highlights Dr. Kohn, Chief Health Officer, actively participated on the Affinia Health Board. New Quality Manager, Allan Mingus, hired August 2015. Quality department was restructured and goals and objectives reviewed and revised. Received National Committee for Quality Assurance (NCQA) Patient Centered Medical Home designation for Leahy site in June 2015. Started working on recertification for Baker site - due February 2017. Continued Patient Centered Medical Home designation for all sites with Blue Cross Blue Shield Purchased i2i Patient Registry to help facilitate management and reporting of patient data. Patient Portal was implemented in April 2015. HCC hired a dedicated staff member to educate and enroll patients. Received $373,541.00 from insurance companies for quality outcomes. Successfully implemented RN Care Management services for Priority Health patients. HCC exceeded quality targets and earned over $120,000 as a result. Monitored and submitted Medicaid Meaningful Use data for medical and dental providers. Quality Improvement Project - Duplicate Scanned Documents: Created a workgroup to focus on processes to reduce duplicated reports. Quality Assurance / Performance Improvement: • • • • • Occurrence / Incident Reports – reviewed and followed-up on. • Reviewed and follow up on Infection Control Program – reviewed and monitored • Reviewed and monitored Meaningful Use • HCC medical and dental providers are registered under the Medicaid Meaningful Use Program Patient Centered Medical Home (PCMH) Initiatives • National Committee for Quality Assurance (NCQA) for Baker and Leahy sites. • Blue Cross Blue Shield for all sites Quality Assurance / Performance Improvement Committees Workgroups • Quality Assurance / Performance Improvement • Environment of Care • Access • Pharmacy & Theraputics (P&T) • Integrated Care Team • Information Technology • Finality (Quality/Finance) • ICD – 10/DSM-5 • 340 B Compliance Committee • EHR/Chronic Disease • Meaningful Use • Pay for Performance Measures – HCC staff consistently monitor, track, and follows-up on pay for performance measures and patient compliance. • Clinical Performance Measures 2015 Provider PEER Review Total charts reviewed: • Medical 352 • Pediatrics 65 • OB 65 • Behavioral Health 210 • Dental 140 Identified issues were addressed. Cumulative results were reviewed at provider meetings. When indicated, individual follow-up was performed by either Chief Health Officer or Lead providers. PRENATAL LIFECYCLE: FQHC State FQHC Nat’l Medical 2015 2014 2013 % of births less than 2,500 grams 12% 11% 14% 9% 7% 1st Trimester 83% 78% 83% 72% 71% Dental Exams 36% 48% 82% % Breastfeeding 1 week after delivery 44% 30% ---- % Quit smoking by delivery 50% CHILD & ADOLESCENT LIFECYCLE: Medical 2015 2014 Immunization (24 mo) 69% 84% 85% Obesity (13-18) 25% 26% 14% Obesity (5-12) 19% 17% 11% Weight Assessment and Counseling (3-17 years) 68% 66% 34% Annual Asthma Actions Plan (5-10 Years) 75% 47% 38% Annual Behavioral Risk Screening (12-17 years): 59% 64% 53% Annual Asthma Action Plan (11-17years): 55% 35% 38% % Active Smokers (13-18 years) 5% 2013 FQHC FQHC State Nat’l 77% 76% 41% 52% Medical ADULT LIFECYCLE: 2015 2014 2013 Cervical Cancer Screening 60% 66% 69% Breast Cancer Screening 76% 58% 72% Colorectal Screening 47% 37% 41% % of Smoker 39% 39% 37% Tobacco Assessment/Intervention 83% 87% 49% Obesity % (BMI > 30) 50% 50% 50% Weight Screening/Counseling (18-64 years) 28% 40% 37% Annual Asthma Action Plan 34% 24% 27% Dental FQHC FQHC State Nat’l 55% 58% 27% 33% 41% 53% 2015 2014 2013 Completed treatment plans within 12 months 49% 43% 55% Dentures Delivered within 90 days 71% 71% 65% GERIATRIC LIFECYCLE: Medical Immunizations - Pneumonia 2015 2014 2013 59% 55% 58% CHRONIC DISEASE MANAGEMENT: FQHC State FQHC Nat’l 2015 2014 2013 79% 78% 65% 74% 75% 81% 65% 68% 75% 75% 61% 61% 60% 63% 64% CAD Lipid Therapy IVD Aspirin Therapy HYPERTENSION Hypertension < 140/90 DEPRESSION: Number of Patients in Registry 2015 2014 2013 689 692 889 ____ ____ % of patients with a 5 point drop in PHQ score 51% % of patients with a PHQ and follow up visit within 4 to 8 weeks of last New Episode PHQ 29% 24% 25% % of patients with another PHQ before 6 months 65% 70% 46% % of patients with a Self Management Goal within the last 12 months 80% 68% 43% % of patients with a Behavioral Health visit within the last 12 months 40% 35% ____ 2015 Number of Patients 1,199 2014 FQHC FQHC 2013 State Nat’l 1,104 1,117 Blood Pressure < 140/90 (Changed in 2015) 67% 69% 54% Fasting LDL < 100 49% 51% 44% HbA1c less than 8 66% 64% 61% HbA1c less than or equal to 9.0 77% 76% 74% ACE Inhibitors or ARB Medication 82% 70% 68% Microalbumin 65% 66% 64% Documentation of Eye Exams 34% 30% 14% Documentation of Foot Exams 67% 74% 80% Documentation of Dental Exams 18% 15% 11% 62% 69% Be Sustainable, Profitable, & Accountable 2015 Finance Pillar Highlights • • • • • • • • • • Received $373,541 in incentive payments from insurance companies Earned $140,250 in meaningful use dollars Secured commitments of $430,491 for Oakridge Teen Health Center Integrated Care Team average of 18.5 patients seen per day Bottom Line Margin of 8.36% 47 Days Cash on Hand as of December 2015 Medical Days Revenue in A/R – 25.6 Dental Days Revenue in A/R – 6.21 403b RFP process, interview, and selection - The Standard Maintained 340b contract pharmacy relationship with Bensons & Walgreens Pharmacies. • Grants Management - Received the following grant revenue: Federal $1,825,333.86 State $1,264,962.49 Local $ 30,449.00 • Unmodified opinion for 2014 audits conducted in 2015: Financial Audit Single Audit OUTREACH & ENROLLMENT HCC staff educate, assist and enroll clients into Marketplace and Medicaid Insurance Products. 2015 2014 2013 Assisted 3,478 5,486 529 Applications Submitted 1,511 2,171 251 Sliding Fee Scale: A sliding fee scale is offered to patients based on their financial status . Active SFS patients: 2015 2014 2013 665 716 2,208 Pharmaceutical Patient Assistance Program: A staff member helps patients receive free medication through enrollment and monitoring of the Pharmaceutical Patient Assistance Programs. Patients served: 2015 2014 2013 2,147 2,141 2,123 2015 2014 2013 67,255 67,147 66,688 Prescriptions: Technology: • 3 FTE IT Staff • HCC Website and Intranet, Exchange Email, Cloud Based Disaster Recovery, Server Virtualization, Shortel VOIP Exchange, Desktop Virtualization, Cisco, and HP WAN Management. • • • • • • • Great Lakes Health Connect, Health Information Exchange (GLHC HIE) Medical EHR A4 Healthmatics Implemented April 2003 Lab Interface (Mercy Health Partners & Quest Labs) E Prescribing Wellcentive Patient Registry HL7 Dental Dentrix EHR Digital X-Ray Pharmacy Computer Rx HCC staff participate in local, regional, and State networks regarding the use of technology in a medical setting. Be the Healthcare Provider of Choice 2015 Service Pillar Highlights HCC received 1,458 patient survey responses in 2015. Overall results were very positive. HCC distributed internal surveys and also participated with CG-CAHPS, a national patient survey process. Data is distributed to departments and providers for review and feedback. Based on patient and staff feedback, both the Baker and Leahy sites underwent renovations in 2015. Teams were re-located for better efficiencies and both sites were updated and spruced up with painting, flooring, etc. The School HUB sites were fully operational in 2015. Sites include Muskegon Teen Health Center, Marquette Elementary, Nelson Elementary, Muskegon Heights Public School Academy, and Covenant Academy. The HUB had a State Site Review in November 2015 and received an A rating which puts the HUB at full accreditation. The State reviewers were very impressed with school staff, operations, and the high quality of care provided. HCC began offering behavior health services at Oakridge School in May 2015. The new Teen Health Center construction was completed in November 2015, with staff moving in and providing primary care and behavior health services in December 2015. HCC implemented Centering Pregnancy groups in 2015 under a grant through the Michigan Primary Care Association. HCC hired a Community Health Worker (CHW) through a grant opportunity with the Michigan Primary Care Association. The “Linkages Program” offers team based and outreach services to HCC patients. This program is in addition to our local partnership with Muskegon Health Project, “Pathways to Better Health”, where HCC has two assigned CHW’s. 2015 Patient Satisfaction Surveys Ease of Getting Care: The 5 year Goal is to increase VERY SATISFIED rate from 71% to 81%. HCC Internal results showed improvement in the VERY SATISFIED category over the last 4 years (77%) and our first year results from CG-CAHPS was 45% for ALWAYS. (Satisfied and above rate averaged 93%). Staff Relationships: The 5 year Goal is to increase the VERY SATISFIED rate from 78% to 88%. Our VERY SATISIFIED rates have increased over the last 4 years – averaging 84% overall. (Satisfied and above averaged 97%) Facility: The 5 year Goal is to increase the VERY SATISFIED rate from 81% to 89%. The facility VERY SATISFIED rates (67%) increased over 2014, but is lower than the 2012 and 2013 rates. We focused on renovations/improvements at the Baker and Leahy site in 2015/2016. (Satisfied and above rate is 98%). 2015 Patient Satisfaction Survey’s Collected HCC Internal Survey’s collected: Each quarter, HCC staff distributed Internal Surveys to patients after their visit. 1,099 HCC CG-CAHPS Caps/Press Ganey Survey’s collected: CG-CAHPS was developed by CMS to help standardize patient satisfaction/experience questions. This national tool was sent monthly to our patients by a vendor called Press Ganey. Press Ganey managed the distribution and collection of information, and provided HCC access into the data. 359 Total Surveys collected : All survey results are reviewed and monitored by the Quality Department, leadership staff, and Board of Directors. Providers received survey results about them and their team. Feedback is used to improve services and benchmark HCC against other practices. 1,458 2012-2015 HCC Patient Satisfaction Internal Survey Results (All Sites) Very Satisfied Objective: Increase the "Very Satisfied" patient satisfaction rate: 2015 Very Satisfied & Satisfied 2014 2013 2012 Combined 73% 75% 71% 98% Ease of Getting Care Goal 81% 2015 77% Staff Relationships 88% 82% 80% 79% 78% 97% Facility 89% 67% 65% 71% 81% 98% # of Responses 1,099 1,075 967 409 2015 HCC Patient Satisfaction CG-CAHPS/Press Ganey Survey Results (All Sites) Domain/Question Survey Response No Yes, somewhat Recommend this provider office Yes, definitely Total No See provider within 15 min of appointment Yes Total 0 1 2 3 4 Rate provider 0-10 5 6 7 8 9-10 Total Access to Care Domain Never How many times visit this provider? Phone for appt for care right away? How often get urgent appt Sometimes as needed? Make appt for check-up/routine care? How often get appt soon as needed? Phone Usually w/question during office hrs? How often get answer same day? Phone w/question after office hrs? Always Get answer as soon as needed? How often see provider within 15min? Total Office Staff Quality Domain No Yes somewhat Clerks/receptionists helpful? Clerks treat with courtesy/respect? Yes definitely Total Physician Communication Quality Domain No Yes somewhat Provider expl in way you understand? Provider listen carefully to you? Talk with provider re prob/concern? Give easy to understand instruction? Know important info medical history? Show Yes definitely respect for what you say? Spend enough time with you? Total Test Results Domain No Yes Provider order test for you? Someone follow up with results? Total # of 2015 % Responses 3.9% 14 13.6% 49 82.5% 296 359 33.3% 118 66.7% 236 354 0.8% 3 0.0% 0 0.6% 2 0.6% 2 1.1% 4 1.7% 6 1.1% 4 4.2% 15 9.5% 34 80.4% 288 358 8.7% 14.2% 31.9% 45.3% 361 1.3% 10.8% 88.0% 358 1.7% 8.4% 89.9% 361 19.5% 80.5% 215 HCC implemented Centering Pregnancy group services in 2015. The first group was held in June 2015. HCC provided 5 groups in 2015 with an average size of 5 participants per group. Feedback from both patients and staff is very positive – they like the teaching/learning style and interactions between patients. Community Outreach Events: HCC staff is committed to reaching out to the community at health fairs, festivals, back to school programs, church events, and other community outreaches. Number of community events: 2015 2014 2013 62 52 55 2015 2014 2013 5,516 6,296 5,024 Number of patient contacts: Stanford Model Chronic Disease Workshops: Grandparents Raising Grandchildren Program: HCC offers a 6-week, 2 ½ hour once per week workshop that builds confidence for managing health, staying active and enjoying life. 2015 2014 2013 Number of Workshops: 2 4 4 Participants 10 25 29 “You Are Not Alone” is a program that provides support groups and education for grandparents raising their grandchildren. 2015 2014 2013 Number of families 44 42 40 Number of Kids 55 53 66 Community Health Workers (CHW): HCC offers the “Pathway’s to Better Health” and “Community Linkages” programs to our patients. CHW’s assist patients with medical, housing, education, transportation, etc. PATHWAYS: Patients: 2015 2014 2013 72 82 151 LINKAGES: 2015 Patients: 67 Breast & Cervical Cancer Program: This service provides eligible women clinical breast & pelvic exams, pap smears and mammograms free of charge. Number of Women seen in the Breast & Cervical Program 2015 2014 2013 64 163 209 Susan G. Komen Grant: Since 2007, HCC has received grant funding to provide breast health education and awareness to community residents, coordinate free mammograms, offer emergency funding, and partner with local organizations in hosting a bi-annual Community Mammogram Party. Number of Women that received free mammograms: 2015 2014 2013 188 232 179 Number of Outreach Events: 2015 2014 2013 63 56 27 COMMUNITY CARE PHARMACY Total customers served: Number of prescriptions: Average daily prescriptions: 2015 2014 2013 5,152 5,644 5,317 76,800 79,149 75,175 300 310 283 Referrals: The referral staff schedule tests and appointments for patients. They also facilitate communication and processes between HCC, the patient, the specialty provider, the hospital, and insurance companies. Medical 2015 2014 2013 Tests 5,362 6,708 5,973 Specialists 7,318 7,625 6,713 1,023 1,077 667 23 31 30 Dental Dental Specialists Medical Provider Referrals Lab Tests: Lab staff offer convenient on-site services to patients. 2015 2014 2013 In-house: 17,925 18,037 18,481 Sent-out: 35,415 18, 245 17,119 School Programs Teen Health Center Muskegon High School • Muskegon Middle School • Services include: – Medical Services – Behavioral Health Counseling – Dental Services Services include: – Behavioral Health Counseling – Nursing Services – Dental Services Visits: 2015 2014 2013 Visits: Medical/ Behavioral Health 2,710 2,634 2,192 Behavioral Health/ Nursing 744 836 650 Dental 2014 2013 414 504 403 42 Patients: 2015 2014 2013 941 Behavioral Health/ Nursing 1,853 1,712 1,716 259 Dental 40 56 51 2015 2014 2013 Medical/ Behavioral Health 935 1,183 Dental 283 444 Patients: Dental 2015 School Programs Teen Health Center Oakridge High School Muskegon Heights Public Academy • • Services include: – Medical Services – Behavioral Health Counseling Services include: – Behavioral Health Counseling 2015 Visits: Patients: 117 56 2015 Visits: 104 Patients: 337 School Programs Muskegon Covenant Academy • Services include: – Behavioral Health Counseling Marquette Elementary • Services include: – Behavioral Health Counseling – Nursing Services 2015 Visits: Patients: 327 63 2015 Visits: Patients: 1,203 335 School Programs Nelson Elementary School • Services include: – Behavioral Health Counseling 2015 Visits: Patients: 668 91 Hackley Community Care and Community Mental Health opened the Integrated Health Clinic (IHC) in January, 2012. The IHC offers a patient centered medical home to Community Mental Health patients. Number of visits: Number of patients: 2015 2014 1,513 1,356 1,181 308 246 2013 208 In June 2012, HCC partnered with Spiritual Care Consultants to offer on-site spiritual care services to our patients. This partnership lines up with our philosophy to treat the whole person: Mind, body, and spirit. 2015 2014 2013 Number of patients served: 34 42 64 Number of patient visits: 85 101 208 Casual For A Cause: HCCC staff pay $2.00 to wear jeans on Friday. Money collected is donated to community agencies (Love Inc., Rescue Mission, Meals on Wheels, Mission for Area People, etc.) Amount of money donated since 1997: Total donations: $43,975 HACKLEY COMMUNITY CARE