PCare4NHV Community Report

@PCare4NHV Spring 2014

Understanding Primary Care Access in New Haven Through

Community-Based Participatory Research A Report of the 2012-2014 Yale Robert Wood Johnson Foundation (RWJF)

Clinical Scholars & Community Partners

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@PCare4NHV Spring 2014

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Community-Based Participatory Research (CBPR)

§ CBPR to engage community members for expertise on primary care access § Over 200 community members contributed (see what types of people below)

Studying: The Why & The How

Why Primary Care & Medicaid?

Questions No One Could Answer Before PCare4NHV

§ How many primary care providers are there in the New Haven area? § What services do they provide? § What is the access for adult patients with Medicaid?

§ Identified 391 providers at 98 adult primary care practices in New Haven area § Visited 89 practices & asked questions the community identified as important

(site visits conducted September 2013 through February 2014)

§ Primary care is a main access point into the healthcare system § Affordable Care Act (Obamacare) increases number of adults with Medicaid

What We Did

Community-Based Participatory Research (CBPR)

§ Facilitated discussions about experiences accessing primary care § Community organizations who helped identify important factors included:

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@PCare4NHV Spring 2014

Making an appointment • 50 (56%) accepted new patients with Medicaid • 19 (21%) offered appointments after 6:00p • 24 (27%) offered weekend appointments • 48 (54%) had Spanish-speaking staff

Accessing: What We Found

Getting to the practice • 88 (99%) within a five-minute walk from bus stop • 77 (86%) provided free parking • 72 (81%) had curb cuts for wheelchair entry • 82 (92%) had a wheelchair accessible main entrance

At the practice • 27 (30%) had a wheelchair accessible counter • 23 (26%) do not require photo ID at check-in • 15 (26%) provided full privacy among 57 assessed waiting areas • 38 (43%) offered cultural training for providers or staff • 30 (34%) offered trauma-informed care training for providers and staff • 45 (50%) had Spanish-speaking providers • 70 (79%) used an electronic medical record • 19 (21%) were designated patient-centered medical homes

After the appointment • 52 (58%) offered a summary after the appointment • 45 (50%) had an online portal for patients to access their records • 20 (22%) provided social work services • 17 (19%) had an on-site pharmacy

@PCare4NHV Spring 2014

Revised 6/12/14

@PCare4NHV Spring 2014

Questions?

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E-mail [email protected]

Blog http://pcare4nhv.wordpress.com

Twitter @PCare4NHV

Understanding: What This Means v Fewer practices accept new patients with Medicaid versus new patients overall

➤ Newly insured patients with Medicaid may face challenges accessing primary care

v Approximately 1/4 of practices offer weekend and/or evening appointments ➤ Some ‘after-hours’ primary care access for working patients

v Almost all practices are within a five-minute walk from a bus stop ➤ Patients can access primary care through use of public transportation

v Approximately 1/4 of practices provide fully private check-in experience ➤ Opportunity to improve privacy for patients

v Approximately 1/4 of practices do not require a photo ID at check-in ➤ Primary care access may be limited for vulnerable populations unable to present a photo ID

v Less than half of practices offer cultural training for providers and staff ➤ Opportunity to improve the experience of patients from different cultures

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Robert Wood Johnson Foundation (RWJF) 2012-2014 Clinical Scholars v Jason Lott v Arjun Venkatesh v Jennifer Voorhees v Ilse Wiechers

PCare4NHV Research Assistant v Christina Cutter

PCare4NHV Primary Care Advisory Team

v Sharon Anderson, Fair Haven Health Center v Lou Brady, Cornell Scott Hill Health Center v Darcey Cobbs-Lomax, New Haven Project Access v Mario Garcia, New Haven Health Department v Lauren Kelly, New Haven Project Access v Georgina Lucas, RWJF Clinical Scholars Program, Yale School of Medicine v Kate McEvoy, Connecticut Department of Social Services v Robert Nordgren, Northeast Medical Group, Yale New Haven Health System v Natasha Ray, New Haven Healthy Start v Maurice Williams, Yale Center for Clinical Investigation

PCare4NHV Facilitated Discussion Partners v Christian Community Action Health Kitchen Cabinet, Members v New Haven Family Alliance Male Involvement Network, Members v New Haven Healthy Start Consortium, Members v Project Access, Patient Navigators v Yale School of Public Health Community Alliance for Research and

Engagement, Community Needs Assessment Surveyors

The 200+ People Who Spoke With Us About Primary Care in New Haven

RWJF Clinical Scholars Steering Committee for Community Projects

RWJF Clinical Scholars Faculty