ACCESS’s Commitment to Quality Care

ACCESS Family Care notes the performance results detailed in the April 17 Kaiser Health News report on the quality of care provided to the close to 1,200 federally funded health centers in the United States. The data provides a lot of positive information considering the rapid growth in patient care experienced by ACCESS over the past few years. Over a three year period we doubled the number of patient visits, with many of the new patients experiencing their first doctor visit or health care checkup in many years. Fortunately, these individuals received services before their health care challenges jeopardized their lives or livelihoods.

• We do exceptionally well with our low birth weight numbers; for 2010 we excelled with 89.06% prenatal patients getting care in the 1^st trimester.
• % children immunized: our grant goal is 89.29% which is higher than the Healthy People (80%) 2020 goal. We still have work to do. Our 2010 result is 61.43%. Our challenge here is the recognition that some parents take their children to several different places for immunizations thereby providing a documentation challenge. We (ACCESS) have to have proof of those immunizations before we can sign off. The Healthy People 2020 Immunization goals often require more immunizations than most area schools require, so parents only opt for what is required by the schools for their children. This also creates a documentation challenge for us.
• Our diabetic patient results are positive. The Healthy People 2020 goals are less than or equal to 9% HbA1c at 85% or higher. In 2011 we raised it to 85.71% even though it was low at 68.57%. (This is the average for all our diabetic patients who have results across the scale.)
• The PAP test results comparisons have difficulties to consider: many of our patients are new over a three year period and may have had on-schedule tests done at other locations, but we have to document it at ACCESS in order for it to count.
• We show improvements with our Hypertensive patients in part by bringing patients back more frequently for blood pressure checks. We educate and encourage patients to self-manage with the Chronic Care Model. (Engaging the patient in their health care, setting up goals for education, diet, exercise, etc.) We also check the blood pressure of our dental patients. 

“We are treating the sickest of the population who have no access to mainstream medical care,” said Don McBride, ACCESS Family Care Chief Executive Officer. “The Kaiser report is beneficial in that it provides a snapshot of the community health centers’ performance across the country.”

At ACCESS, in areas where the data demonstrates room for improvement, we are making those improvements.  Beginning this May 1, the start of our new fiscal year, we begin the hiring process to add a quality improvement and chronic care specialist,” said McBride. “It will be this person’s responsibility to monitor the data and make changes as needed to continuously improve health outcomes.”

The quality improvement position is part of ACCESS’ three-year improvement plan which began with the major implementation of the electronic medical record three years ago. All ACCESS data is posted into a state-level depository where the information compared with other health centers. The data is also shared with a federal database for comparisons purposes.

Kaiser Health News studied the individual performance of health centers compared to the average for all health centers, and to the average for the entire U.S. population on the six measures of care.

ACCESS participates in the Missouri Community Health Centers formalized quality improvement efforts which began in 2006 with the establishment of the Missouri Center for Primary Care Quality and Excellence initiative in anticipation of an increasing expectation to quantify and demonstrate high quality care.

ACCESS Family Care was founded in 1996 as a Federally Qualified Health Center (FQHC) for the purpose of increasing access to primary health care for those who lack medical insurance coverage. As an FQHC, ACCESS receives a 330 Federal grant from the Bureau of Primary Health Care designed to offset the expenses associated with providing sliding fee discounts to patients who demonstrate economic need. Economic need is based on federal poverty guidelines, total household income, and total people living in the household. The grant funds are only 16% of ACCESS’s overall 2012-13 budget and ACCESS is spending over 100% of those grant funds to serve the medically underserved.

ACCESS Family Care operates centers in Anderson, dental and medical; Cassville, medical and dental; Joplin, dental, medical, pediatric care; and Neosho, medical. Administrative offices are located in Neosho.

ACCESS Family Care is committed to the mission of improving the health of the medically underserved of greater southwest Missouri through direct services and collaborative efforts. ACCESS serves this mission through the values of Compassion, Access, Respect, and Excellence.