Greater New Orleans Primary Care Safety Net Access Plan
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In the spring of 2012, as part of the White House Strong Cities Strong Communities initiative (SC2), the City of New Orleans, with assistance from the U.S. Department of Health and Human Services (HHS) and the Robert Graham Center, undertook an effort to understand the current and projected capacity of the primary care safety net in the New Orleans area in order to meet the needs of the population and adapt to anticipated market changes in 2014.
Dr. Karen DeSalvo, Health Commissioner for the City of New Orleans, co-chaired a collaborative effort with Dr. Anjum Khurshid from the Louisiana Public Health Institute (LPHI). They were aided by an advisory group of 15 community members, consisting of leaders from an array of backgrounds including non-profit staff, hospital system executives, government officials, and representatives from the private insurance industry.
The result of their work is the Greater New Orleans Primary Care Safety Net Access Plan, a comprehensive overview and set of policy recommendations for healthcare access in the New Orleans area for use in planning and policy-making, in order to achieve and maintain equitable access to care.
Key Findings and Areas of Focus
Primary Care Sustainability:
The network of primary care safety net clinics is not financially stable. Therefore, there is the need to build stronger business functionality and expand capacity in order to meet the current and growing demand and to remain competitive in 2014.
Low-income patients have long wait times for access to specialty care services, or no access at all. There is a need to develop a more systematic way of using available specialty services efficiently.
Health Information Technology (HIT):
The primary care safety net has a high adoption of HIT but requires continued investments and upgrades in the HIT infrastructure to enable improved care coordination, to reduce system fragmentation and to improve the public’s health.
Coverage and Finance:
More than 130,000 adults and children are uninsured in the New Orleans area and will need help with viable long term options for public and private financing of their healthcare.
New Orleans needs additional capacity and resources for behavioral health services in the primary care, community and inpatient settings.
New Orleans will need to train, recruit and retain the primary care workforce including physicians, health professionals and other members of a healthcare team. A detailed study should be conducted to propose a long-term action plan for developing the healthcare workforce.
Reducing the Burden of Chronic Disease:
The City, State and local providers should support evidence-based best practices, policies and programs that enhance health and the impact of the healthcare system by addressing social and non-medical determinants of health, rather than medical services alone.
Primary Care and Public Health Integration:
The City of New Orleans should collaborate with the healthcare system, including the local information exchange, to build the evidence base for developing and evaluating public health policy.
Communication and Outreach:
The public is generally unaware of the available primary care safety net and the challenges faced by this safety net to provide essential healthcare services. The City of New Orleans and its partners should aggressively work to increase the awareness of services and healthcare funding options for area residents.
The primary care safety net should ensure that it is prepared for all hazards through hardening of facilities and through building technology and other infrastructure that can assure continuity of care.