A Quarterly Resource Bulletin from Capital Link

Spring 2016 Issue    

Message from the CEO

Allison Coleman, CEO

With today's advances in data and technology, many industries are now able to move beyond simply tracking the past to anticipating the future and even predicting behavior. In this issue, the article How Health Centers Can Use Predictive Analytics, discusses how more and more health centers are using this concept to improve patient care, reduce costs, and negotiate favorable contracts with payers.

Also in this issue, we are making another plea for participation in our annual national capital needs assessment. Even if you don’t have any plans for capital projects in the near future—or if your plans are still preliminary—we urge you to complete this very short survey. We know you are busy, so we’ve reduced the survey to just five questions. Your participation is greatly appreciated!

We also congratulate the ten health centers chosen to participate in the Healthy Futures Fund Readiness Program, a technical assistance program for health centers seeking to advance their innovative, co-located projects through Healthy Futures Fund (HFF) financing. Details on the participating centers and the program are included in this issue.

As always, this issue contains a federal update, links to new resources, health center highlights, and a list of our upcoming events and webinars. We hope you find this information helpful.

Federal Update

Keep Up to Date!

Below is a selection of recent health policy and regulatory news and information relevant to health centers and PCAs. For regular updates, subscribe to Capital Link’s blog and access the following links:

NACHC’s Health Centers on the Hill and Policy Shop blogs

The Health Resources and Services Administration’s health center tab

The newsroom at the U.S. Department of Health and Human Services

HHS Awards over $260 Million to Health Centers Nationwide to Build and Renovate Facilities to Serve More Patients

On May 4, 2016, HHS Secretary Sylvia M. Burwell announced over $260 million in funding to 290 health centers in 45 states, the District of Columbia, and Puerto Rico for facility renovation, expansion, or construction. These awards will allow health centers to renovate or acquire new health center clinical space to help provide care to over 800,000 new patients nationwide. This investment builds on the nearly $150 million awarded to 160 health centers from the Affordable Care Act’s Community Health Center (CHC) Fund for construction and/or renovation in September 2015. To view a list of the award winners, click here.

HHS Awards $94 Million to Health Centers to Improve Substance Abuse Services

On March 11, 2016, HHS Secretary Sylvia M. Burwell announced $94 million in Affordable Care Act funding to 271 health centers in 45 states, the District of Columbia, and Puerto Rico to improve and expand the delivery of substance abuse services in health centers, with a specific focus on treatment of opioid use disorders in underserved populations. This investment is expected to help awardees hire approximately 800 providers to treat nearly 124,000 new patients. For more information on these awards, including a list of award winners, click here. 

Aligning Reporting of Clinical Quality Measures 

On February 18, 2016, the Centers for Medicare & Medicaid Services (CMS) and America’s Health Insurance Plans (AHIP), as part of a broad Core Quality Measures Collaborative of health care system participants, released seven sets of clinical quality measures.  These measures support multi-payer alignment, for the first time, on core measures primarily for physician quality programs. This work is informing CMS’s implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) through its measure development plan and required rulemaking, and is part of CMS’s commitment to ensuring programs work for providers while keeping the focus on improved quality of care for patients. Learn more here.

New Access Point Funding Opportunity

HRSA recently announced the 2016 New Access Point (NAP) funding opportunity, which provides operational support for new primary health care service delivery sites. Subject to the availability of appropriated funds, HRSA anticipates awarding approximately $50 million to support an estimated 75 New Access Point awards in Fiscal Year 2017. The maximum annual funding that can be requested in a NAP application is $650,000.  NAP applications must be submitted via Grants.gov by June 17, 2016. Supplemental materials are due July 15, 2016. Awards will be announced prior to the Jan. 1, 2017 start date. The funding opportunity announcement and guidance can be found here. 

New Markets Tax Credit Program Update: CDFI Fund Combines 2015 and 2016 Rounds

On April 18, 2016, the Community Development Financial Institutions Fund (CDFI Fund) announced it is combining the calendar years 2015 and 2016 New Markets Tax Credit Program (NMTC Program) allocation authorities into one allocation round and increasing the awards from $5 billion to $7 billion. The CDFI Fund will not re-open the combined 2015-2016 round for new applications. All allocation determinations will be made from the existing pool of applications submitted for the 2015 round. The CDFI Fund received 238 applications requesting an aggregate total of $17.6 billion in NMTC allocation authority. By combining the 2015 and 2016 allocation rounds, the CDFI Fund will be able to announce the allocation of New Markets Tax Credits in the year for which they are authorized, and will be able to help more communities access the benefits of the tax credits sooner. Currently, the CDFI Fund anticipates announcing the CY 2015 – 2016 NMTC Program allocations in late 2016. Read more here.

If your health center has a capital project on the horizon, now is the time to act! To find out how Capital Link can help your health center capitalize on this financing option, please contact Jonathan Chapman, Director of Community Health Center Advisory Services at 970-833-8513 or This email address is being protected from spambots. You need JavaScript enabled to view it.. We expect to offer a series of NMTC readiness workshops and free technical assistance this summer, so let us know if you are interested in participating. Details will be announced shortly. 

To learn more about the NMTC program and how it works, access our resource Spotlight on Capital Resources: New Markets Tax Credit Program Update. Also note, we plan to release a new NMTC resource in the next few weeks, so keep an eye out for our email announcement.

CMS Announces Funding Opportunity to Discover How Addressing Social Needs can Improve Health 

On January 5, 2016, the Department of Health and Human Services announced a new funding opportunity of up to $157 million to test whether screening for health-related social needs and facilitating navigation of community-based services will improve quality and affordability in Medicare and Medicaid. The goal of the five-year Centers for Medicare & Medicaid Services (CMS) Innovation Center program, called the Accountable Health Communities Model, is that beneficiaries struggling with unmet health-related social needs are aware of the community-based services available to them and receive assistance accessing those services. A link to the funding announcement can be found here.

New and Noteworthy

Health Centers Selected for Healthy Futures Fund Readiness Program 

We’re delighted to announce that ten innovative health centers have been selected to participate in the Healthy Futures Fund Readiness Program, a technical assistance program offered through Capital Link to prepare health centers for Healthy Futures Fund (HFF) financing. The HFF is a $200 million collaboration between the Local Initiatives Support Corporation (LISC), Morgan Stanley and The Kresge Foundation designed to promote healthy communities—with capital financing resources specifically designated for Federally Qualified Health Centers (FQHCs) that are addressing the social determinants of health through a co-location model.

Participating health centers include:

• Alivio Medical Center with The Resurrection Project, Chicago, IL

• Blackstone Valley Community Health Care, Central Falls, RI

• El Centro del Barrio (dba CentroMed), San Antonio, TX

• Esperanza Health Centers, Chicago, IL

• First Choice Community Healthcare, Albuquerque, NM

•  Hill Country Community Clinic, Redding, CA

• Legacy Community Health with Avenue Community Development Corp., Houston, TX

• NOELA Health Center with Mary Queen of Vietnam, New Orleans, LA

• New Economics for Women (possible collaboration with Arroyo Vista Family Health Center), Los Angeles, CA

• Primary Health Network with Midland Development Corp., Midland, PA

The selected health centers have planned projects that combine access to health care with a variety of services designed to address broader community concerns, including affordable and/or supportive housing; physical fitness and wellness centers; community gardens, urban farms and healthy foods; early childhood education and charter schools; and financial, technology and employment training.

The HFF Readiness Program has two primary components:

1. Group Learning: Webinars will provide education on New Markets Tax Credit (NMTC) financing, particularly through HFF, and what it takes to be ready to successfully obtain financing. Participants will also benefit from the experiences of other health centers that have taken on projects to address the social determinants of health — and have obtained NMTC financing to advance these projects.

2. Individualized Advisory Services: Capital Link consultants will help participants understand whether or not the HFF NMTC financing structure would be advantageous for their needs, and if so, develop a specific work plan to achieve readiness for financing. This assistance includes identifying areas of needed operational or financial improvement to be addressed through the planning grant phase.

Those that successfully complete the HFF Readiness Program will be eligible to apply to LISC for grant funding to advance their capital project planning and can be considered for financing through HFF. Congratulations to all participants!

How Health Centers Can Use Predictive Analytics 

Using data and technology, organizations can now move beyond simply tracking the past to anticipate the future through the use of predictive analytics, technology that learns from experience [data] to predict the future behavior of individuals in order to drive better decisions. Predictive analytics is now becoming more applicable to health care, and will eventually become essential for health centers to improve patient care, reduce costs, and negotiate favorable contracts with payers.

Health Centers can utilize predictive analytics in a multitude of ways, furthering its consideration and implementation of patient engagement, patient compliance, chronic disease management, regulatory compliance, avoidable deaths, hospital readmissions, public health, waste and abuse, and health outcomes. And this is only the beginning. Clearly predictive analytics is in its infancy within health care, and the exponential pace of technological advancements will identify additional uses and benefits we have yet to consider.

Capital Link and NACHC are putting the finishing touches on a new resource on predictive analytics that is not intended to provide instruction on coding or building predictive models, but will:

• Define predictive analytics

• Provide an overview of its history and development

• Address the data and resources needed to predict a patient’s future behavior

• Identify how a health center can begin utilizing it

• Include specific examples of how it has been successfully used

• Clarify health centers’ understanding and expectations of predictive analytics

Just 5 Brief Questions to Help Us Update Our National Capital Needs Assessment 

Capital Link is updating our national capital needs assessment, with support from HRSA, to help document the need for health center capital funding and identify areas where technical assistance, training, or other resources may be needed.

The participation of all US health centers is critical! Even if you don’t have plans for a facility expansion project in the near future—or if your project plans are still preliminary—your participation is still important.

 (It should take no more than a few minutes to complete.)

Access the results from our last national capital needs assessment, Capital Plans and Needs of Health Centers: A National Perspective, here on our website.

Thank you for your assistance in this important effort.

Resources

New Reports Examine the Financial and Operational Trends of California Health Centers

Capital Link announces the release of an updated statewide financial and operational profile and an analysis of the financial sustainability of rural health centers in Northeastern California. These resources, sponsored by Blue Shield of California Foundation, highlight data trends in an effort to identify opportunities to ensure financial sustainability, particularly given the changing nature of the healthcare landscape. We are scheduling webinars in June to review key findings from these studies. Stay tuned for more information!

California Community Health Centers: Financial & Operational Performance Analysis, 2011-2014 updates Capital Link’s statewide, multi-year financial and operational profile to promote performance improvement. Click here to download the report.

Analysis of the Financial Sustainability of Rural Health Centers in Northeastern California sheds light on the unique challenges confronting frontier and rural health centers and offers ideas for strengthening operations. Click here to download the report.

New NACHC Research Department Resources

Staffing the Safety Net: Building the Primary Care Workforce at America’s Health Centers: This new report presents results from NACHC's recent national health center survey of health center clinical vacancies, hiring priorities, and recruitment and retention experiences. If all health center clinical vacancies were filled today, health centers could serve two million more patients. Click here to access the report.

Updated State Fact Sheets: NACHC’s recently updated fact sheets provide a brief overview of what health centers are, the most important state-level data available on health center patients, services provided, staff, patient visits, and costs of care. A national profile is also available. Click here and find your state on the map at the bottom of the page. Find NACHC fact sheets and infographic here.

Find summaries of research articles related to different community health center topics—quality of care, improving access to care, and cost-effectiveness—here.

Coming Soon from Capital Link: 

• Spotlight on Capital Resources: New Markets Tax Credit Program Update 2 (Publication)
• Predictive Analytics: An Overview for Health Centers (Publication) 
• Creating a Culture that Sustains a Patient-Centered Medical Home (Publication)
• Informing the Development of a Patient-Centered Medical Home Facility (Publication)

Health Center Highlights

Capital Link regularly profiles health centers that have successfully completed their expansion plans. These health center stories are available on our website. Recent additions include Neighborhood Health Association, OH, and Family Healthcare of Hagerstown, MD (formerly Walnut Street Community Health Center).

GE to Invest in Massachusetts Community Health Centers...
On April 4, 2016, amidst plans to relocate its global headquarters from Connecticut to Boston, MA, GE announced it will be making $50 million in philanthropic donations in Massachusetts over the next five years. The company specified a commitment to donating $15 million through its GE Foundation to expand capacity and increase specialty care training at Massachusetts community health centers. As a part of this funding, GE will also be building the first-ever Community Health Center Leadership and Skills Institute, which will offer training for health centers across the state on leadership, team-based care, and the use of technology to improve patient outcomes. Read more here.

Upcoming Events

Events

National Health Center Week 2016 is August 7-13 and Capital Link is proudly sponsoring this important event. This year's theme is Celebrating America's Health Centers: Innovators in Community Health.  

Industry Presentations

Capital Link regularly presents information at industry conferences. Below are a few of our next scheduled events. Complete descriptions are available here on our website.

Northwest Regional Primary Care Association Spring Primary Care Conference
Anchorage, AK
May 14-17, 2016

Hallmarks of Operational Excellence - Using Benchmarking Techniques and Operational Improvement Tools for Effective High-Quality Operations
Monday, May 16th
Presenter: Jonathan Chapman, Director of Community Health Center Advisory Services, Capital Link
Read more here.   

 
California Primary Care Association Chief Financial Officers Conference
Carlsbad, CA
May 18-19, 2016

Strengthening Health Center Collections through Effective Revenue Cycle Management
Wednesday, May 18
Presenter: Dale Johnson, Project Consultant, Capital Link; and Patricia Aguilera, Chief Financial Officer, La Clinica de la Raza 
Read more here.   

Mid-Atlantic Association Of Community Health Centers Semi-Annual Conference
Annapolis, MD
June 16, 2016

Market Assessment and Payer Mix Modeling in an Era of Health Reform
Thursday, June 16, 3:15-4:15 pm
Presenter: Rebecca Polan, Project Consultant, Capital Link
Read more here.   

Missouri Primary Care Association Annual Clinical & Quality Conference
Branson, MO
September 24, 2016

Hallmarks of High Performance: Exploring the Relationship between Clinical, Financial and Operational Excellence at America’s (and Missouri’s) Health Centers
Saturday, September 24, 2016, 8:30-10:00 am
Presenter: Allison Coleman, Chief Executive Officer, Capital Link

Webinars

Capital Link offers seasonal series of webinars designed to offer useful information for health centers on a wide range of topics. The webinars have no charge, but participation is limited to the first 100 registrants. Please check our website for complete descriptions of all upcoming webinars.

California Health Center Performance Update
Wednesday, June 1, 2016, 1-2 p.m. PT (Hosted by CPCA)
Presenters: Tony Skapinsky and Dale S. Johnson, Project Consultants, Capital Link
Register here.

Financial Sustainability for Rural Health Centers in Northeastern California
Thursday, June 9, 2016, 1-2 p.m. PT (Hosted by CPCA)
Presenter: Jonathan Chapman, Director of Community Health Center Advisory Services, Capital Link
Register here.

Planning for Growth: Health Center Board and Staff Training
Tuesday, June 14, 2016, 2-3 pm EDT
Presenter: Jonathan Chapman, Director of Community Health Center Advisory Services, Capital Link
Register here.

Accessing Capital from Community Development Financial Institutions
Wednesday, June 15, 2016, 2-3 p.m. EDT
Presenter: Terry Glasscock, Senior Project Consultant, Capital Link
Register here.

Incorporating Capital Plans into Strategic Planning Efforts
Thursday, June 23, 2016, 2-3 p.m. EDT
Presenter: Rebecca Polan, Project Consultant, Capital Link
Register here.