Team-based care is changing the future of work for FQHCs

Burnout is everywhere in healthcare — but have you considered how a team-based care model can mitigate it? It’s not only by sharing the work, but also by not feeling alone when confronting the big issues facing vulnerable communities. Working at an FQHC can be stressful, overwhelming, and even demoralizing at times, but the work can also be incredibly fulfilling. It’s the reason so many committed community members come to work — and they want to be doing more to be of use to your center.

FQHCs are part of the puzzle to address poverty and engage in this work every day. But confronted with these big challenges, many staff members feel helpless in this mission. Some are unsure how their roles contribute to the overall mission and they realize, over and over again, how hard it is to support every incoming patient, every community member, day in and day out.?

This month, we’re highlighting the importance of a team-based care model and its ability to increase staff satisfaction, reduce burnout, and improve the patient experience which, in turn, improves patient trust. Having supported numerous FQHCs with their on-the-ground efforts, I’ve found the team-based way of working benefits everyone — administrative staff, clinical providers, patients, and community members — and is setting a new standard for the future of primary care. Learn more about adopting this model below.

Best,

Lora Council, MD

[Former] Chief Medical Officer

Yuvo Health

In today's email:

• Adopting team-based care to improve quality outcomes
• 3 questions with Mary Ellen Driver, CEO of Advantage Care Health Center
• Industry links

Adopting team-based care to improve quality outcomes

Team-based care isn’t new, but it’s rising in popularity among primary care providers and proving to be an important factor in value-based care models. While most FQHCs have prioritized whole-person health for decades, many are starting to consider more efficient ways of delivering high quality care to patients and driving better health outcomes.?

With limited staff and resources, it’s easy to put more responsibilities on clinical providers, social workers, and others who are highly trained to work with patients on clinical issues. But this needs to change, says Lora Council, MD, [former] Chief Medical Officer at Yuvo Health. Clinical staff can be freed up to focus on clinical work when administrative responsibilities and data gathering, among other tasks, can (and should) be taken over by other people in the office, such as medical assistants or front desk staff or by technology solutions such as patient self-scheduling or text message based screenings.?

In a team-based care model, every person surrounding the patient is considered a valuable member of the “team.” This includes front desk staff, assistant nurses, social workers, the pharmacy, the dentist, the billing department, and the administration, says Dr. Council. Rather than hiring more clinical staff or more administrative workers, FQHCs should assess their existing teams and how they can more efficiently accomplish tasks.

Some ways to adopt this model:

• Identify a clear, common goal within your center, such as making the patient experience as seamless as possible.
• Find out why your staff members have chosen to work at your center – and ask what roles and responsibilities they’d be interested in taking on.
• Build your own workforce. Hire students out of high school or college and provide job training.?
• Train and promote from within, understanding that existing staff are willing to learn and grow with you and your mission.
• Give each staff member more agency to contribute in more meaningful ways.
• Improve the system of communication between all staff members, including clinical providers and administrative staff.
• Recognize the value of each staff member, as they all play a vital role in your center.
• Understand that mistakes will happen as your staff members shift to this new way of working.

While you can’t adopt this new model overnight, as it requires shared trust and understanding, you can take actionable steps to eliminate silos and create a more collaborative team environment. And over time, you’ll need to change your systems and processes.?

What does this look like in practice? One example includes having medical assistants, nurses, and others fill out forms before handing them to physicians. Another includes giving non-clinical more information and more responsibility that doesn’t require a license, so they can refer patients to local food pantries, remind patients of Medicaid redetermination, offer them diapers if they’re expecting, and talk them through difficult-to-understand paperwork. Rather than “dumping” more tasks on the component of the workforce with the least amount of training, these office changes need to be implemented in an incremental, supportive way that recognizes the amount of local knowledge and good will all staff bring to the health center.

This new team-based care model will change the patient experience — and lead to better quality care, delivery, and outcomes — by unlocking every staff member’s ability to be a dedicated contributor.

3 Questions with Mary Ellen Diver, CEO of Advantage Care Health Centers

Q1: Why is it so important for FQHCs like Advantage Care to consider value-based care?

FQHCs sometimes feel like we’re one step behind other types of care providers in terms of how we can innovate, but that’s not the case. There are so many opportunities to engage with the evolution of the healthcare systems, whether that’s through grants and recognition programs or partnerships with payers and value-based care experts. Value-based care is coming, but that doesn’t have to be a scary thing. You just need to find the right partners and invest in the right practice transformation efforts to get prepared for the care coordination and population health management activities required.?

Q2: What does the future look like for Advantage Care?

Because we serve something of a niche population with our intellectual and developmental disabilities (IDD) folks, we need to work with other FQHCs to have enough of the right mix of patients meet some of the quality measures that we typically don’t have the chance to address in our patient panel, such as maternity-related metrics. As a team, however, we now represent a much wider and more varied population – that gives everyone a better chance of filling in gaps that they might not be able to meet on their own based on the patients they serve… We don’t need to reinvent the wheel, and we don’t need to do this in isolation. That’s incredibly comforting and empowering. Healthcare is moving toward a very bright future, and we are ready to be a leader in this new era of care.?

Q3: Why did Advantage Care partner with Yuvo Health?

We knew from the start that we were aligned with Yuvo’s mission. We believe they understand the unique needs of the population we serve, including our IDD patients, and we’re thrilled about how we’ve been able to innovate together and bounce ideas off each other as we continue to explore how value-based care is going to work for FQHCs. We are a relatively small FQHC with about 2500 patients across our two care sites. By joining the Yuvo IPA, we’re now in an entity with ten times that many patients, which really increases our clout when we’re at the table with managed care plans.

“These days, FQHCs have so many reporting programs; so many public report cards. They’ve got staffing issues and grant applications and trainings. And unfortunately, a lot of them don’t have the most transparent and equitable relationships with their health plans, so they’re not getting everything they deserve out of those interactions.”

— Deborah Johnson Ingram , Senior Director of Performance Improvement at PCDC

Industry links

NYSDOH confirms telehealth Medicaid coverage to continue through 2024

Telehealth services continue to be a lifeline for countless Americans across the country – and New York State Medicaid plans to continue providing telehealth services to Medicaid employees through December 2024, ensuring that care is more accessible for patients.

Unveiling challenges and triumphs: Michigan Federally Qualified Health Centers efforts in implementing bluetooth-enabled self-measured blood pressure monitoring

A new study reveals the benefits of using bluetooth-enabled self-measured blood pressure monitoring (BT SMBP), a blood pressure monitoring system, to improve hypertension control. Findings show that positive staff attitudes are tied to expected patient outcomes and perceived benefits of the system.

After end of pandemic coverage guarantee, Texas is epicenter of Medicaid losses

All across the country, people have lost – and are losing – Medicaid coverage, but Texas is seeing the worst of it. Over half a million Texans have lost convergence within the first month, and largely because of paperwork issues.

North Carolina sees transforming healthcare landscape

To ensure more people are insured, North Carolina is revamping the state’s certificate of need (CON) program, which will expand Medicaid expansion and ensure that thousands are insured in spite of nationwide Medicaid losses. ?

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