Primary Health qualifies as patient-centered medical home

The patient-centered medical home is a quality ranking for primary care. It requires doctor practices to organize care around patients, work in teams, and coordinate and track care over time. One of the key aspects of federal health care reform is to change the way health providers are paid, tying reimbursements to quality outcomes instead of the current way that ties payments to volume of patients.

Primary Health received the accreditation January this year. Level III is the highest level that can be obtained.

At the time Primary Health was accredited, officials said it was one of three federally qualified health centers in Ohio to achieve the certification.

“We can demonstrate the quality of care that we can provide,” Marc Bellisario, Primary Health chief executive officer, said.

Primary Health formed in 2004 when the former Butler County Community Health Consortium joined together with the former Middletown Social Service and Health Center.

It was designated in 2007 a Federally Qualified Health Center. That means it receives funding from U.S. Dept. of Health and Human Services, to help care for the medically underserved and Medicaid population in Butler County. Primary Health offers services on a sliding fee scale; the amount patients pay for services depend on their income and household size.

Even though Primary Health receives funding to provide care to the uninsured, anyone can use its services including people who have no insurance, commercial insurance or government-backed insurance (Medicaid). Its health centers in Hamilton and Middletown offer full family care including adult medicine; pediatrics; prenatal; women’s health and behavioral care; chronic disease management; dental services; physicals; and laboratory services.

Prior to receiving the independent certification, Primary Health made a series of changes the last two years to qualify.

Doctors now have time set aside to see new patients everyday. There’s not a waiting list to get in anymore like there was in past years, Peggy Vazquez, Primary Health’s director of clinical operations, said.

Primary Health has developed a closer relationship with Community First Pharmacy, located next door to the Hamilton health center on South 2nd Street. The Community First pharmacist volunteers to do medication management evaluations of Primary Health patients.

A partnership was reached about a year ago for nursing students from Miami University to help patients set self-management goals and work with patients to achieve the goals.

Over the past four years, Primary Health has been developing a partnership with Butler Behavioral Health Services. Behavioral health counselors are on-site at the health centers to see patients.

“With this partnership, we take care of their patients who don’t have primary care. They take care of our patients. The agreement is if we have somebody that needs the help, they get in right away. There’s not a wait list for our patients,” Vazquez said.

Primary Health reached in February a partnership similar to the one with Butler Behavioral with Solutions Community Counseling and Recovery Centers, a behavioral health services agency in Warren and Clinton counties. Primary Health opened a new office in Wilmington this year at Solutions Community to see their behavioral health patients one day a week.

Also the nonprofit health centers are using an electronic registry system to help manage their patient population. The system tells them, for example, how many diabetic patients they have and their range of blood test results. Primary Health uses the data to figure out what’s going on in that population, and why some people’s blood tests are lower or better than others. Then they reach out to patients who need to improve to see if they’re meeting their medical appointments and taking medications correctly.

Primary Health’s electronic medical record system interfaces with the registry and with HealthBridge, a Cincinnati information technology organization. HealthBridge tells Primary Health if one of their patients uses another health care provider in greater Cincinnati, and updates the patient’s electronic medical record automatically.

As a result of the changes, patients “should see a difference in the way their care is provided and they should feel that they’re going to get better results,” Bellisario said.

Primary Health is also adding new services, most recently launching a dental van program to provide on-site dental care to children in Butler County schools and other under-served populations. A 40-foot-long bus was outfitted with two patient chairs, full treatment X-ray and waiting area.

Butler County has a growing unmet need to provide health services to the working poor, the jobless and uninsured, fueling greater demand for Primary Health’s services. Primary Health adds an average 300 new patients a month.

The working poor — people who have jobs but can’t afford health care — have become one of Primary Health’s biggest customers.

“The people that are making minimum wage that have a family, even if it’s one child and minimum wage, you can do the math. You cannot support yourself and have health insurance and the expectations are overwhelming. And those are the people that are getting squeezed,” Vazquez said.

Primary Health Solutions Time Line

SOURCE: Primary Health Solutions

2004 - Butler County Community Health Consortium joined together with the Middletown Social Service and Health Center to create the present day organization.

2007 – Butler County Community is designated as a Federally Qualified Health Center.  The designation provides funding to assist in the care of the medically underserved and Medicaid population in Butler County.

2007 – The new Bever Health Center opens to expand service in Hamilton

2008 – BCCHC serves approximately 8,500 people in the community

2010 – BCCHC changes its name to Primary Health Solutions; the name change connects the locations through a common name which better identifies the mission and work of the organization

2010 - PHS converts to Electronic Medical Records – regionally becoming one of the first FQHC’s to go electronic

2010 - PHS opens a new health center on the west side of Hamilton to improve access to care for pediatrics, and women’s health care

2011 - PHS adds pre-natal care to the West side office to fill the gap left by Planned Parenthood when they discontinued pre-natal services. 

2011 – In December of 2011 PHS opens a new state-of-the-art  22,000 sq ft health center in Middletown, the new health center doubled capacity for health providers including the much needed expansion to the dental program.

2012-PHS in partnership with Butler Behavioral Health Services begins services at Harbor House in Hamilton. 

2012-PHS doubles patients served and serves over 15,000 people in the community

2013 – PHS receives the coveted quality award of a Level III Patient Centered Medical Home from the National Council for Quality Assurance. 

2013 – PHS in partnership with Solutions Community Counseling begins services for patients in Wilmington, Ohio

2013 – Mission Dental arrives- Mission Dental is a mobile dental center which will provide services to children in Butler county schools.

2013-PHS applies for a new access point grant to open an office in Franklin and Oxford, Ohio.  This move will expand access to care for residents of Warren county and northern Butler County.  Status of grant in process.  Grant awards will be made in July of 2013

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