Health Affairs

Here are some more examples of foundations’ efforts. This is just a sampling, not a comprehensive listing, of what foundations have been doing.

Rhode Island Foundation and Rhode Island Lieutenant Governor Announce Creation of Statewide Coalition for Primary Care

Announced at a May 27, 2010, event, the new coalition, “which will coordinate efforts to improve access to primary care in Rhode Island,” is a result of the Making It Work: Health Reform in Rhode Island series, which is jointly sponsored by the Rhode Island Foundation and Rhode Island Lieutenant Governor Elizabeth Roberts (D), according to an e-mail alert. The series brings “national leaders in health reform together with business and community leaders, medical providers, insurers, educators, consumer advocates and policy makers, to chart the course for a new, affordable, high quality health care system in Rhode Island.”

This third event in the series was standing room only, according to the funder. Paul Grundy of IBM was the keynote speaker. Breakout sessions included discussions of “the role of hospitals in primary care,” “opportunities in the federal health care reform legislation,” and “health information technology and primary care.”

Owen Heleen, vice president for grant programs at the foundation, commented on its Web site: “Today’s meeting was a major step forward in our signature initiative in primary care. The innovation and dedication of the primary care community will allow our state to become a real pathfinder on the road to comprehensive health reform.”

Related resources:

“Lt. Gov. Backs Medical Home Project,” Denise Perreault, Providence Business News, May 27, 2010.

“RIGHA Foundation and Harvard Pilgrim Health Care Establish $1.6 Million Fund at the Rhode Island Foundation,” Rhode Island Foundation press release, April 21, 2010.

Read more on Rhode Island and primary care:

“Blue Cross to Pay R.I. Doctors More for Complex Patients,” Felice J. Freyer, Providence Journal, May 18, 2010. In this news article, Freyer mentions a May 2010 Health Affairs article by Robert J. Reid of Group Health Research Institute, in Seattle, and colleagues titled “The Group Health Medical Home at Year Two: Cost Savings, Higher Patient Satisfaction, and Less Burnout for Providers.”

“Rhode Island’s Novel Experiment to Rebuild Primary Care from the Insurance Side,” Christopher F. Koller, Troyen A. Brennan, and Michael H. Bailit, Health Affairs, May 2010.

Primary Care in General—A Sampling of Foundation-Funded Efforts:

Evolving Models of Behavioral Health Integration in Primary Care, a May 2010 report by Chris Collins, North Carolina Department of Health and Human Services; Denise Levis Hewson, Community Care of North Carolina; Richard Munger, Buncombe County (North Carolina) Human Services Support Team; and Torlen Wade, Community Care of North Carolina, was commissioned by the Milbank Memorial Fund. The authors suggest ways to meet “the unmet needs of the millions of Americans suffering from mental illness and substance abuse”—that is, integrating primary care and behavioral health care, according to an e-alert. The report summarizes available evidence on integration as well as states’ experiences using it “as a means for delivering [high-]quality, effective physical and mental health care.” The authors suggest eight models of integration. The report points out that “mental health care delivered in an integrated setting can help to minimize stigma and discrimination, while increasing opportunities to improve overall health outcomes.”

The Health Affairs articles cited in the  post today (June 3) and many other articles are in the May 2010 issue, which has the theme “Reinventing Primary Care.” The United Health Foundation, California HealthCare Foundation, CVS Caremark, ABIM Foundation, and American Academy of Physician Assistants funded this thematic issue. Watch the well-attended issue briefing, held in Washington, D.C., on May 4, 2010.

“Health Care Incentives Can Work,” Jim Knickman, president and chief executive officer of the New York State Health Foundation, Huffington Post, May 28, 2010. In this post, Knickman mentions another May 2010 Health Affairs article, by Daniel Fields, Elizabeth Leshen, and Kavita Patel titled “Driving Quality Gains and Cost Savings through Adoption of Medical Homes.” Since that article was written, Patel has been named director of the health policy program at the New America Foundation.

“Improving Access to Primary Care in a Reforming Environment” was the title of a breakout session I attended at the Grantmakers In Health (GIH) annual meeting back in March 2010. This session focused on an initiative of the Quantum Foundation, located in West Palm Beach, Florida, to increase the number of federally qualified health centers (FQHCs) in Palm Beach County. Look at the now-closed RFP for this initiative here.

The initiative aimed to establish new FQHC sites and expand services at existing sites. The speakers at this GIH session included Claude Earl Fox, executive director of the Florida Public Health Institute (and former administrator of the federal Health Resources and Services Administration [HRSA]), Christine Koehn, vice president for programs at Quantum, and Toni May, Quantum’s director of community relations. This foundation had been funding free clinics but realized there was a need to focus on increasing the number of FQHC sites; the initiative included converting free clinics to FQHCs. Fox pointed out that among the advantages of FQHCs is that they have a guaranteed source of income, and they have access to health professionals from the National Health Service Corps. Quantum’s efforts included providing technical assistance and transitional funding to encourage free clinics to convert to FQHCs. Koehn suggested to session attendees that foundations wanting to increase the number of FQHCs could fund capital costs and renovations of buildings as well.

Among the lessons learned by Quantum staff, Koehn said, was that the capacity of the free clinics has increased when they converted to FQHCs. Free clinics serve a definite role, she said, but the foundation feels strongly that they should try to transition to FQHC status, as that is a more sustainable model. Quantum is not a funder that provides ongoing, sustainable funding for any one specific grantee. Fox later added that every clinic that converts to FQHC status is “serving as many or more uninsured” people as when it was a free clinic. May told the GrantWatch Blog in a telephone interview about another lesson Quantum had learned:  Because medical residents who work at an FQHC qualify for federal assistance with their student loans from medical school, talented medical residents want to work at the centers.

Watch a video of Foundcare, one of Quantum’s grantees. Are you thinking that Palm Beach County is all people without any challenges? Read the “Did You Know?” section accompanying the video.

Read a 2009 GrantWatch column describing the work of Baptist Community Ministries (a private foundation in Louisiana) to establish an FQHC in New Orleans.

“Structuring Payment for Medical Homes,” Katie Merrell of Social and Scientific Systems Inc., and Robert A. Berenson of the Urban Institute, Health Affairs, May 2010. The authors discuss four approaches to pay medical “practices that serve as medical homes.” The Commonwealth Fund supported the research on which this paper is based.

Some additional foundations that have funded or will fund in the area of primary care:

Healthcare Georgia Foundation, located in Atlanta.

Josiah Macy Jr. Foundation, located in New York City, which released an important April 2010 monograph: Who Will Provide Primary Care and How Will They Be Trained?

St. Luke’s Health Initiatives, located in Phoenix, Arizona, which recently published two issue briefs on primary care. The first, Goodbye, Hello—Framing the Future of Primary Care: An Arizona Perspective, Part One: The Primary Care Parade, was published in December 2009. The other, Goodbye, Hello—Framing the Future of Primary Care: An Arizona Perspective, Part Two: Bending the Possibility Arrow, was published in January 2010.

Harry and Jeanette Weinberg Foundation, located in Baltimore, Maryland. See “Goals for Health.”

Related resources:

“Doctor Shortage Creating Quiet Health Care Revolution,” MSNBC video, May 30, 2010. NBC chief medical editor Nancy Snyderman, who is a physician, says “many states have turned to nurse practitioners [NPs] as an answer for the ailing [health care system].” She discusses an NP practice in Easton, Maryland.

“Insurance Firm Has Incentive for Primary Care Doctors,” Josh Goldstein, Philadelphia Inquirer, April 30, 2010. Read about Independence Blue Cross’s plan “to pay physicians more if their patients’ health improves.” Among the goals of the initiative is “to ease a primary-care doctor shortage.”

This entry was posted on Thursday, June 3rd, 2010 at 9:20 pm and is filed under Access, GrantWatch, Mental Health, Nurses, Physicians, Primary Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.