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North Bay clinics earn high scores in federal rankings

Dr. Nurit Licht does a well child check on 15-month old Lucero Patricio-Lopez who is held by her father Tiburcio Patricio-Amador at the Petaluma Health Center on Monday.

BETH SCHLANKER/Press Democrat
Published: Monday, July 22, 2013 at 3:00 a.m.
Last Modified: Monday, July 22, 2013 at 11:33 p.m.

Uncle Sam has a new way of measuring the performance of community health centers, and to no one's surprise local clinics like Petaluma Health Center are receiving some pretty good marks.

For the first time, the federal Health Resources and Services Administration has released rankings for quality of care at community clinics.

The rankings allow the public and health care administrators to assess the performance of community clinics, which treat more than 81,000 patients in Sonoma County and are slated to play an increasingly important role in caring for people under Obamacare.

It also allows the government, and the public, to keep tabs on their investment.

Petaluma Health Center, which has undergone a major expansion of both facilities and medical programs, ranked among the highest in the state in a number of categories related to preventative medicine, which some in health care view as a key toward reducing rising health care costs.

“It's all about keeping people well so that we can reduce health care costs and unnecessary utilizations,” said Teresa Tillman, chief administrative officer.

Petaluma ranked in the first quartile — the top 25 percent of similar health centers in the nation — in five of 12 categories tracked by the government. It received high scores for the percentage of female patients who received pap tests (69.6 percent); tobacco users who received cessation advice and or medication (70.8 percent); and the percent of women receiving their first prenatal visit in the first trimester (89 percent.)

In the case of early prenatal visits, “it means that patients are getting early prenatal care which should lead to better outcomes,” said Danielle Oryn, Petaluma Health Center's medical director.

Under President Obama's Patient Protection and Affordable Care Act, some 30 to 33 million uninsured Americans will be covered by health insurance, primarily through an expansion of Medicaid, known as Medi-Cal in California.

Federally-qualified health centers, which receive beefed-up Medicaid reimbursement rates, are expected to provide primary health care to a significant share of the newly insured.

After passage of Obamacare, state and local health officials jumped at the opportunity to be part of early expansion of Medicaid. The program, called Bridge to Reform, has enrolled more than a half-million state residents in advance of the nationwide Medicaid expansion scheduled for next Jan. 1.

To date, community health centers in California see 5.2 million patients, according to the California Primary Care Association, which represents community clinics across the state. Of these, 1.3 million are currently uninsured and will become eligible through expanded Medicaid and the state's health exchange program, Covered California.

“That doesn't even speak to the uninsured individuals who are currently not patients,” said Carmela Castellano-Garcia, president and CEO of the California Primary Care Association.

“We know we'll have a significant demand, including those who are not patients,” she said.

She said that clinics like the Petaluma Health Center, West County Health Centers and the Santa Rosa Community Health Centers have all been undergoing significant expansions to prepare for what's expected to be a flood of new patients.

Castellano-Garcia said she was not surprised to see Petaluma Health Center do so well in its rankings. As part of the Redwood Community Health Coalition, which represents 16 health centers in Sonoma, Napa, Marin and Yolo counties, the Petaluma clinic has benefitted from a number of supportive health care initiatives, including early adoption of electronic health records.

Such regional health center networks are non-existent in some states.

“The entire RCHC network was really ahead of the curve,” Castellano-Garcia said. “They are the first clinic association that adopted the same (electronic health record system)... It doesn't surprise me that this top health center is coming out of the RCHC.”

The federal Health Resources and Services Administration has been compiling data provided by clinics since 1996. The data comprises the core set of information used in reviewing the operation and performance of health centers. The data tracks a variety of information, including patient demographics, services, staffing, clinical indicators, costs and utilization rates.

“The data are reviewed to ensure compliance with legislative and regulatory requirements, improve health center performance and operations, and report overall program accomplishments,” HRSA spokesman Martin Kramer, said in an email.

The quartile rankings were devised last year and presented to the public for the first time this year, Kramer said. The current rankings are based on care provided in 2011.

Naomi Fuchs, CEO of Santa Rosa Community Health Centers, said the clinical measures will become more useful as data collection improves.

“This was the first year reporting on these measures and we are all learning how to best document what we do for patients,” Fuchs said in an email. “SRCHC looks at many quality indicators, including the ones reported in the (federal database), and has many quality initiatives to continuously improve the health of our patients.”

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