Transcript Document
Founded in 1995 by the National Association of
Community Health Centers, Community HealthCorps
is the largest health-focused, national AmeriCorps
program that promotes healthcare for America’s
underserved, while developing tomorrow’s healthcare
workforce.
The mission of Community HealthCorps is to improve
healthcare access and enhance workforce
development for community health centers through
national service programs.
The vision of Community HealthCorps is to become a
national service pipeline for careers in community
health centers that is improving access to necessary
primary and preventative care services for the
medically underserved.
For further information about Community HealthCorps,
visit www.communityhealthcorps.org
Performance Measurement
Moving Patients Towards the Outcomes
Agenda
• What are the Community HealthCorps®
Performance Measures (PMs)?
• How can PM outcomes guide our impact on
those we serve?
• How do we measure that impact of our service?
• Practice putting it all together!
• How do we report our impact?
• Summary…
• Additional Resources
Member Training
What are the Community HealthCorps®
Performance Measures?
Why Do We Serve?
• 1 in 5 Americans have little or no access to
primary health care and are considered
“medically underserved.”
• 40% of Americans cannot explain
a deductible.
• American families pay $900 in higher
premiums each year to compensate for
unpaid medical debt.
• 6,500 New York seniors could save taxpayers $73
million/year if they lived in their own home.
• Individuals with a stronger
social network have a lower
risk of institutionalization.
Performance Measures
ACCESS TO CARE: educating economically disadvantaged individuals
about health insurance, management of chronic conditions, and
navigation of the health care system to help increase proper utilization
of preventive and primary care services.
FINANCIAL LITERACY: emphasizing economic opportunity with a focus
on engaging economically disadvantaged individuals in improving their
financial knowledge as it relates to health care.
INDEPENDENT LIVING: assisting older adults and individuals with
disabilities with receiving food, transportation, or other supportive
services that help them to live independently.
Access to Care
Needs and
Assets
They lack
knowledge
about the use of
available
preventive and
primary care
services
Inputs
Activities
Output
Outcome
Community
HealthCorps
Members
Insurance
submission:
helping a client
enroll into
health insurance
Number of
individuals who
received
assistance with
signing up for
insurance or a
health
service/program
Number of
individuals
enrolled (from
the output) who
indicate
increased
knowledge
about effective
utilization of
preventive and
primary care
services
Grant funds
Health center
staff
Registration:
helping a client
sign up for a
health service or
program
Financial Literacy
Needs and
Assets
Individuals lack
knowledge of
the link
between health
decisions and
impacts on
economic
opportunities
Inputs
Activities
Output
Outcome
Community
HealthCorps
Members
Financial Case
Management
Number of
adults served
with the
activities related
to financial
literacy
Number of
adults served
(from the
output) who
indicate
increased
financial-health
knowledge
Grant funds
Eligibility
Assistance
Health center
staff
Financial
Education
Insurance
Outreach
Independent Living
Needs and Assets
Inputs
Activities
Output
Outcome
Older adults &
individuals w/
disabilities face
barriers to
maintaining
independent living
Community
HealthCorps
Members
Insurance
Submission
Registration
Grant funds
Case Mgmt.
Health center staff
Outreach
Number of older
adults and
individuals with
disabilities served
with the defined
activities
Number of older
adults &
individuals w/
disabilities served
(from output) who
indicate increased
knowledge about
support services
and programs
Health and
Financial Ed.
Eligibility
Assistance
Interpretation
Services
Member Training
How can Performance Measures guide
our impact on those we serve?
Moving People Towards the Outcome
Performance Measures act as a guide for your service!
Without PMs, you are
providing services without
direction or a purpose
PMs give you an
understanding of why you are
providing certain services
Overview of Outcomes
• Community HealthCorps® has identified 6 topics that are
important for improving clients’ knowledge about their
health:
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Health insurance
Medications and prescription assistance
Managing your health
Wellness and prevention
Understanding your health
Finding services and resources
Click here to learn about how these topics relate to the
Community HealthCorps® Performance Measure outcomes.
Member Background
• Access to Care: CMS From Coverage
to Care Roadmap
• Financial Literacy: CFBP Your Money,
Your Goals training
• Independent Living: asset mapping
training (1, 2)
Member Training
How do we measure that impact of our
service?
Independent Living Outcome
• Program Site randomly assigned to
Independent Living for measuring outcomes
• Outcomes will be measured by
providing clients with a pre and postactivity questionnaire
– Corresponds directly with the
Independent Living content for each topic
Example Independent Living Questionnaire
How do you score this? The score is the average for before and after. Add the
“before” numbers together then divide by the number of questions to get the
pre-score. Do the same with the “after” numbers to get the post-score.
Example Independent Living Questionnaire
How do you score this? The score is the average for before and after. Add the
“before” numbers together then divide by the number of questions to get the
pre-score. Do the same with the “after” numbers to get the post-score.
Independent Living Sample Scripts
•
Pre measure = agenda for engagement
– PRE: “Before we begin, I’d like to ask you if you would mind completing this short
questionnaire about how familiar you are with the topics that we will talk about today. It’s
only a few questions and will help to give me a better understanding of your needs. Your
answers to these questions will help me know what types of resources and information I can
share to help you. There are no right or wrong answers, and you’ll be able to take this
questionnaire with you after we’re done talking today.”
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Post measure = summary of engagement
– POST: “Now that we have talked about (discuss briefly what you did/gave them/referrals
made/next steps etc.), I’d like you to answer the same questions we started with. Would that
be OK?”
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End of engagement = topic list
– END: “Thank you so much for helping me out. Your participation
helps me know what information is helpful and how I can help
other patients like you in the future. Please take this
questionnaire with you. I also want to show you some of the
other topics that patients like to discuss with me just in case you
have additional questions or would like to come by again.”
Pre/Post Questionnaire Logistics
• Administered only once per person
• Every 10th person served who is an older adult
or person with a disability
• Client can take
the questionnaire
with them
Member Training
Practice putting it all together!
Practice Scenarios
Write down…
1. Scenario number
2. Service activities performed
3. Topic and content area provided
4. Social determinants of health
addressed
5. Special populations served
6. Yes or No: Should there be a pre/post
measurement?
Practice Scenario 1
A young adult patient comes into the health center to talk with
someone about health insurance coverage. He signed up for coverage
through the Marketplace, was enrolled in a plan, and now has no idea
what to do next. He doesn’t have a primary care provider. Review
various health insurance terms, the type of plan, and the services
covered by the plan with the patient. Then, help him make an
appointment with a doctor at the health center.
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Service Activities = Financial Education, Registration, and NonFinancial Case Management: Facilitation
Topic: Health Insurance
Content Area: Financial Literacy and Access to Care
Social Determinants of Health = N/A
Special Populations = N/A
Pre-/Post-Measurements = No
Practice Scenario 2
It is your first day of service, and you are working a booth at the
Annual Community Health Fair! The first person who comes to your
booth is a 72-year-old woman who tells you that she recently went to
the ER because she ran out of her diabetes medication and has no
transportation to get to a clinic. Explain to her the differences between
the services provided by the ER and the community health center, and
give her a brochure for Access Ride, a local service that provides
transportation to and from medical appointments.
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Service Activities = Primary Care Outreach, Non-Financial Case
Management: Facilitation
Topic: Understanding Your Health
Content Area: Access to Care
Social Determinants of Health = Transportation Assistance
Special Populations = Older Adults
Pre-/Post-Measurements = Yes
Practice Scenario 3
For MLK Jr. Day of Service, you are helping an elementary school class build a
vegetable garden. There are 6 children in this class, including one who is in a
wheelchair. You begin the day by teaching them about the importance of
healthy eating and how their new garden will help them reach the goal of
eating 4 servings of vegetables every day.
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Service Activities = Nutrition Education
Topic: Wellness and Prevention
Content Area: Access to Care and Independent Living
Social Determinants of Health = Food Assistance
Special Populations = Persons with Disabilities, Children Under 18 who are
overweight, obese, or at risk of becoming overweight/obese
Pre-/Post-Measurements = No (children do not receive the pre/post
questionnaires)
Note: Each of the children would be reported individually using the Individual Reporting Form.
Practice Scenario 4
A young mom and her 2 children come into the health center where
you’re serving to sign up for health insurance. After finding out some
information about her income, it is clear that she is not eligible for
Medicaid. Help her sign her children up for CHIP benefits. Explain the
services covered and review CHIP terminology.
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Service Activities = Insurance Submission, Eligibility Assistance,
Financial Case Management: Assessment
Topic: Health Insurance
Content Area: Financial Literacy and Access to Care
Social Determinants of Health = N/A
Special Populations = N/A
Pre-/Post-Measurements = No
Note: Only the mother would be reported as being served for this engagement.
Member Training
How do we report our impact?
The Excel Spreadsheet: Overview
• Tool and step-by-step instructions on Community HealthCorps®
website
• Data includes:
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Your name
An ID number for the patient
Length of engagement
Service activities performed
Social determinant of health addressed
Special populations served
Outcome pre & post measurement scores
The Excel Spreadsheet: Section 5
Type into each field the:
• Outcome pre measure score
• Outcome post measure score
– A number = score
– R = client refused
– N/A = client not able to provide
information
– U = Member unable to administer
pre or post measurement
– Blank = outcome not measured
because doesn’t apply
Member Training
Summary & FAQs…
Summary
• Everyone that a Member touches should leave
learning something new.
• Members should provide a pre/post
questionnaire to every 10th person who is
served under Independent Living.
• Members should report the pre/post scores
on their Direct Service Reports.
Member Training
Additional Resources
Additional Educational Resources
Click on the pictures below for more information.
Member Training
Questions?