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p r i mar y car e
44
MAR / APR 2013
I
Healthcare Journal of NEW ORLEANS
federal loan repayment incentives to come
practice in NewOrleans.” HHS contributed
$35 million to help fund the expansion and
retention of the primary care and men-
tal health workforce in the Greater New
Orleans area. Griffin also cites a major
focus on strengthening a community-wide
disease registry and the development of
a Health Information Exchange with the
hospitals. “Focusing on infrastructure
development and coordination of care as
a whole, anchored by medical homes and
primary care, sets us apart from other cit-
ies,” said Griffin.
Despite the success of primary care in
the New Orleans area, challenges remain
to make the network more sustainable and
more resilient. The primary-care safety
net is unstable and heavily reliant on pub-
lic funding – particularly for the care of
the uninsured. Health rankings remain
low, and there are still issues with con-
necting residents with the services avail-
able to them. For example, thousands of
uninsured children in the New Orleans
area qualify for Medicaid or LaCHIP, but
are not enrolled. Similarly, although num-
bers are down from 34% in 2006, 27% of
Orleans Parish residents polled by the
Kaiser Family Foundation in 2010 still
reported that their usual place of care was
in the emergency room, or that they did
not have a usual source of care. For the
uninsured, 51% report their usual source
of care is the emergency room, despite
other resources being available to them.
Last year, the City of New Orleans
Health Department, with assistance
from HHS and the Robert Graham Cen-
ter, undertook an effort to understand
the current and projected capacity of the
primary care safety net in New Orleans.
Health Commissioner Dr. Karen DeSalvo
and Dr. Anjum Khurshid from the Louisi-
ana Public Health Institute (LPHI) assem-
bled an advisory group of 15 community
members, consisting of leaders from non-
profit organizations, hospital systems, pri-
vate insurance, and government entities,
with the goal of developing a comprehen-
sive overview and set of policy recommen-
dations for healthcare access in the New
Orleans area. The resulting greater New
Orleans Primary Care Safety Net Plan,
released by the City of NewOrleans Health
Department, identifies several opportuni-
ties to enhance the primary care safety
net, to create one more resilient for disas-
ter, everyday life, and ready to compete in
the 2014 marketplace. Key findings and
areas of focus to strengthen the primary
care safety net include the following:
Primary Care Sustainability:
The net-
work of primary care safety net clinics is
not financially stable. Therefore, there is
the need to build stronger business func-
tionality and expand capacity in order to
meet the current and growing demand and
to remain competitive in 2014.
Specialty Care:
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 fragmen-
tation, 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.
Behavioral Health:
New Orleans needs
additional capacity and resources for
behavioral health services in the primary
care, community, and inpatient settings.
Focusing on
infrastructure
development and
coordination of
care as awhole,
anchored by
medical homes
and primary
care, sets us apart
fromother cities.
–
Michael Griffin