Restructuring Care In A Federally Qualified Health Center To Better Meet Patients' Needs

SYSTEM Clinica Family Health Services, a Colorado federally qualified health center, serving a region extending from the Denver outskirts through Boulder to the Continental Divide. It served 38,450 patients in 2010; half were uninsured, and 40 percent were enrolled in Medicaid. KEY INNOVATION Patients faced long waits for appointments at Clinica and seldom saw the same provider from one visit to the next. Low-income patients with chronic conditions found it difficult to sustain preventive care, keep appointments scheduled weeks in advance, or make additional appointments with a social worker or mental health counselor. Clinica retooled operations to offer same-day appointments for comprehensive services. Group visits, especially to provide prenatal care, emphasize patient education and make use of group dynamics to promote better health. COST SAVINGS By preventing more than 40 premature births in 2010, Clinica saved the health care system $2.1 million in that year alone. QUALITY IMPROVEMENT The national average for low-birthweight babies is 8.2 percent, but just 6 percent of babies born to Clinica patients are underweight. The rate is even lower-just 5.3 percent-among mothers who opt to receive prenatal care through Clinica's group visit program. CHALLENGES Offering multidisciplinary care is more expensive than conventional office visits and exceeds the costs of Medicaid's current reimbursement rates in Colorado. Although Clinica's program probably saves the state money overall on its Medicaid budget, possible state budget cuts threaten the clinic's ability to provide comprehensive services.