What’s the current state of the safety net in western and central New York? How can stakeholders in the regions work together to build the capacity of the primary care safety net to ensure that it meets community need, improves the quality of care and strengthens the overall primary care system?
To help answer these questions, the Health Foundation for Western and Central New York and John Snow, Inc. presented the WNY and CNY Primary Care Safety-Net Assessment reports and recommendations at events in Buffalo and Syracuse, NY on February 27 and 28, 2014. These assessments provide information to stakeholders throughout the regions on the capacity and strength of the existing primary care system and provide recommendations to consider as they move forward in order to take advantage of the dramatic changes that are occurring in our health care system.
Since May 2013, JSI conducted primary care demand and capacity assessments, consumer surveys, an extensive series of interviews and site visits with primary care practices and other stakeholders, and environmental scans to understand the impact and implication of the Affordable Care Act.
So what did they find? JSI looked at three areas:
Community Need, Demand and Access
- Lack of access to after-hours care, especially for children
- High rates of emergency department use for adults and children
- Significant wait times for appointments for adults and children
- Need for improved communication between provider and patient
- Limited access to behavioral health and dental care services
Provider Supply/Capacity and Strength
- FQHCs and hospital-affiliated practices play a major role in the safety net in most communities in western New York.
- Urgent care clinics are growing in many markets and are reducing burden on emergency departments
- Still a substantial unmet need in the region
Environmental Context
Strengths include:
- Strong and growing core safety net, including solid FQHC and hospital-based networks
- Development of integrated delivery systems
- Strong MCH, social service, and refugee organizations
- Federally-funded hospital emergency department diversion programs
- Existence of SNAPCAP in WNY
- Strong health department support in CNY
- Planning and assessment resources
- Strong academic and workforce development resources
Weaknesses include:
- Inherent competition among safety net
- Some providers struggling financially
- Limited collaboration across safety net
- Organizational and service specific silos still exist
- Low reimbursement rates
- High rates of hospital emergency department utilization
- Limited development of Patient Centered Medical Home and Accountable Care Organizations
- Lack of specialty care and dental capacity, particularly for low-income residents
Recommendations include:
Strengthen and expand primary care safety net
- Improve quality, patient experience, and clinic efficiency
- Fill capacity gaps
Promote population-based health
- Improve overall health status
- Manage existing chronic disease
Educate and promote collaboration
- Promote communication/information sharing
- Support integrated delivery systems
The Health Foundation will be taking comments on the report from members of the community before finalizing the report in early April 2014.
Any comments should be sent to safetynet@hfwcny.org no later than Friday, March 14, 2014.
