New Plan Identifies Ways to Increase Productivity and Fill Provider Vacancies, Prioritizes Geographic Areas for Growth

Contacts: Stephany Fong, NYHealth, fong@nyhealthfoundation.org
Beverly Grossman, CHCANYS, (518) 434-0767 x.11, bgrossman@chcanys.org

April 8, 2013 (New York) – New York State’s federally qualified health centers (FQHCs) could provide more than 1 million additional visits and serve hundreds of thousands more patients each year, according to a new plan released today. This first-ever plan for building the State’s community health center system projects the gains in capacity that could result from enhancing productivity and improving recruitment and retention of health care providers.

Key findings from the report, “A Plan for Expanding Sustainable Community Health Centers in New York,” prepared by the Community Health Care Association of New York State (CHCANYS) with support from the New York Health Foundation (NYHealth), include:

  • Health centers could deliver 1 million additional patient visits each year and serve 225,000 more patients if all of New York State’s FQHCs had as many visits per full-time equivalent (FTE) as the top 75th percentile of the State’s health centers. Even increasing visits per FTE to just the median could result in hundreds of thousands more visits than are currently provided.
  • If all vacant health care provider positions were filled, the State’s FQHCs could increase patient visits by 800,000 per year, serving an additional 185,000 patients. Expanding the State’s existing provider recruitment and retention programs to fill existing vacancies could produce 720,000 more visits for more than 155,000 patients.

The report also identifies “primary care deserts,” areas in New York State with no FQHCs. While all areas of the State would benefit from additional primary care capacity, the report prioritizes 16 neighborhoods in New York City and 22 counties in other areas of the State with the greatest needs and strongest prospects for expanded primary care resources. [See below for the list of regions.]

“This plan could not be timelier. When federal health reform is fully implemented, we expect 1.2 million New Yorkers to gain health care coverage,” said James R. Knickman, President and CEO of NYHealth. “For those who become newly insured, we need more primary care resources. For those who remain uninsured, we must preserve a strong safety net.”

“Federal health reform makes FQHCs a cornerstone of its plan for expanding access to health care because they are proven to provide high quality and comprehensive care to underserved communities,” said Elizabeth H. Swain, CHCANYS President and CEO. “In New York State, we expect that FQHCs will need to double their capacity to serve nearly 3 million patients by 2015. With support from the federal and State governments and other health care leaders, we are ready to meet that challenge.”

The new report identifies opportunities across four domains to expand FQHCs’ capacity:

  • Development of high-performing community-based primary care. Primary care providers should implement practice redesign strategies that decrease patients’ waiting times; reduce patient no shows; maximize productivity and patient volume; and eliminate waste in their systems. Primary care providers also need support to implement team-based care, enhance their Health Information Technology capabilities, and expand the use of telemedicine.
  • Primary care workforce recruitment and retention. Primary care providers must be able to recruit, train, and retain a workforce that is stable and well qualified to serve low-income patients. Filling vacant positions is an immediate means to expand the capacity of providers to see more patients while implementing longer-term strategies to “grow their own” providers.
  • Access to affordable capital. Capital funds and capital project assistance are needed to help providers build new sites, expand existing sites, purchase health information technology, renovate outdated facilities, and increase patient access through the use of telemedicine and mobile medical vans.
  • Community-level planning. Additional, ongoing planning efforts at the community level will complement regional planning efforts and support the development of expansion plans that are feasible and sustainable.

“The future of health care depends on a robust primary care sector. There are huge opportunities both to derive more capacity of the system that we have and to build a bigger system,” said David Sandman, NYHealth Senior Vice President. “Now we have a rational and data-based plan for creating the primary care services that New Yorkers need and deserve.”

“CHCANYS’ new product does a wonderful job capturing the needs of underserved populations still in need of primary care services in New York State,” said Tom Van Coverden, President and CEO of the National Association of Community Health Centers. “The plan establishes a new level of excellence in community development practices and is a model that should be considered by every primary care association.”

The full report is available here.

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The purpose of the Community Health Care Association of New York State (CHCANYS) is to ensure that all New Yorkers, including those who are medically underserved, have continuous access to high quality community-based health care services including a primary care home. To do this, CHCANYS serves as the voice of community health centers as leading providers of primary health care in New York State. CHCANYS works closely with more than 60 federally qualified health centers (FQHCs) that operate approximately 600 sites across the state. Serving 1.5 million New Yorkers, these FQHCs are central to New York’s health care safety net. For more information, visit www.chcanys.org.

The New York Health Foundation (NYHealth) is a private, statewide foundation dedicated to improving the health of all New Yorkers, especially the most vulnerable. Today, NYHealth concentrates its work in three strategic priority areas: expanding health care coverage; improving diabetes prevention; and advancing primary care. The Foundation is committed to making grants, informing health care policy and practice, spreading effective programs to improve the health system, serving as a neutral convener of health leaders across the State, and providing technical assistance to its grantees and partners.
Priorities for Expanded Primary Care Resources

In New York City, 16 neighborhoods fall into Tier One, the category of highest priority for expansion:

Bronx: Fordham/Bronx Park; Crotona/Tremont; High Bridge/Morrisania; Hunts Point/Mott Haven

Brooklyn: Bedford Stuyvesant/Crown Heights; East New York; Sunset Park; East Flatbush/Flatbush; Williamsburg/Bushwick

Manhattan: Washington Heights/Inwood; Central Harlem/Morningside Heights; East Harlem

Queens: Long Island City/Astoria; West Queens; Flushing/Clearview; Jamaica

In the rest of the State (excluding New York City), CHCANYS conducted separate analyses of 1) counties that were fully rural, 2) the rural areas within “mixed counties (i.e., counties with both rural and urban components), and 3) the urban areas within “mixed” counties. Within each of those categories, CHCANYS identified counties for FQHC expansion:

Fully Rural Counties: Cattaraugus; Chautauqua; Delaware; Franklin; Fulton; Herkimer; Montgomery; Otsego; St. Lawrence; and Sullivan.

Rural Areas Within Mixed Counties: Broome; Chemung; Jefferson; Niagara; Oneida; Ontario; and Wayne.

Urban Areas Within Mixed Counties: Albany; Broome; Chemung; Erie; Jefferson; Oneida; Orange; Rensselaer; and Westchester.

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