摘要:

Health centers' flexibility in meeting changing political and economic demands throughout their history has allowed them to evolve and expand. In 1997, they served 8.3 million patients—40% uninsured and 35% Medicaid recipients. Thus far, most centers have been able to balance their mission of serving the underserved with economic survival. However, their future viability is threatened, by downward pressure on revenues, coinciding more frequently with growing numbers of uninsured patients. The centers' value as essential safety net providers, their adaptation to marketplace realities and their performance in terms of cost and quality outcomes appears to justify the increased subsidy that may be needed for continued operation.

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Across the nation, states are placing their faith in managed care as the solution to the rising health care costs associated with the Medicaid program. Historical providers of care to the vulnerable and uninsured are competing in this new price-sensitive market while struggling to remain faithful to their missions. In Maryland, a unique partnership between an academic health center (Johns Hopkins HealthCare) and a coalition of community health centers has emerged as a model that promises to preserve the financial and philosophical goals of historical providers.

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Medicaid managed care is becoming prevalent throughout the United States, but some commercial HMOs are exiting from the Medicaid market. This phenomenon suggests that success in this relatively new market depends on the development of Medicaid HMOs around the key safety-net providers in the community. These essential providers offer the backbone of expertise and commitment needed to serve the Medicaid population while they are eligible for coverage as well as after their Medicaid eligibility ends.

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Community health workers have been used in health centers for several decades. Known by various names (e.g., community health advisors, outreach workers,promotoras), they are trusted community members providing informal community-based health-related services and establishing vital links between health providers and the community. They perform many functions, including outreach and case finding, health education, translation, patient transportation, and case management (under the supervision of a nurse or social worker). This article, based on a study of community health worker programs at seven sites, is intended to share the lessons learned that could be helpful to other program managers and to examine the outcomes of such programs.

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:The elimination of health status gaps among minority and low income populations is part of the mission of community health centers (CHCs). Cervical and breast cancer incidence and mortality are related to both minority and socioeconomic status, and CHCs are in a unique position, by virtue of their target population, to effect positive outcomes through screening and early detection.Methods:Completed in 1995, the survey described in this article included questions from the 1992 NHIS Cancer Supplement, which collected information on the utilization of cancer-screening services, including Pap smear testing, mammography, and clinical breast examination.Results:CHCs are providing access to Pap smear testing, mammography, and clinical breast examination for women who are at an increased risk for morbidity and mortality associated with cancers of the cervix and breast. A higher proportion of CHC women of most racial and ethnic groups and women below poverty level are up to date on cancer screening than comparison groups. In most cases, CHC women meet or exceed theHealthy People 2000objectives for the nation.

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Since participation in managed care is critical for community health centers'(CHCs) survival, centers must demonstrate their good performance to purchasers (e.g., state Medicaid agencies) and health plans. Such measures also can contribute to quality improvement. Ideally, the effort would use measures and methods widely recognized in the managed care industry, logically the Health Plan Employer Data and Information Set (HEDIS). This article summarizes a feasibility study of applying HEDIS clinical measures to CHCsas providers.It finds that, with concerted, well-directed efforts, it will be possible to use clinical HEDIS measures in health centers.

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This article describes a community-based survey of patients' experiences in community and migrant health centers that was designed to (1) develop a method to measure patients' experiences and (2) create a national database of patient experiences. The project succeeded in surveying the most difficult-to-reach poor and minority populations (mainly Medicaid and uninsured populations) in medically underserved areas, although more than 10% lack ready access to a telephone, another 22% do not speak English well enough to be interviewed in English, and many have limited literacy. We analyzed the responses from 3 perspectives: (1) demographics and health status, (2) dimensions of care, and (3) patient progress through the community and migrant health center system.

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:1999

数据来源: OVID