Access to Health Care in Arizona · 2018-04-27 · National Interest Waiver Program – allows certain foreign workers with advanced degrees or exceptional abilities to work in the

Health and Wellness for all Arizonans azdhs.gov

Access to Health Care in Arizona

Bureau of Health Systems Development

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Bureau of Health Systems Development Mission

• To optimize the health of Arizona residents by developing and strengthening systems services to expand access to primary care and other services with emphasis on the health needs of underserved people and areas








Bureau of Health Systems Development Core Functions

• Serves as the Primary Care Office for Arizona

• Develops and implements strategies for strengthening primary care and the health care delivery system

• Administers programs to increase the number of providers and improve services in underserved areas

• Identifies areas that need improved health services and assists with federal/state shortage designations

• Provides technical assistance to statewide partners








Social Determinants of Health

4

Source: Kaplan GA. Part III summary: What is the role of the social environment in understanding inequalities in health? In: Adler NE, Marmot M, McEwen B, Stewart J, editors. Socioeconomic Status and Health in Industrialized Nations. New York: Annals of the New York Academy of Sciences; 1999. pp. 116–119.








Uninsured Arizona Children Arizona 2010*

7

14.2

11.2

7.2

0 0

2

4

6

8

10

12

14

16

White, Non-Hispanic

Hispanic AmericanIndian

Black Asian/PacificIslander

Perc

ent

*The Healthy Development of Arizona’s Youngest Children A 21st Century Profile of Opportunity and Challenge; Arizona Health Survey 2010 Survey Data for Children 0-5








Uninsured Arizona Residents Arizona 2010*

9.6

28.8

19.6

12.6 13.4

0

5

10

15

20

25

30

35

White, Non-Hispanic



Perc

ent

n=305

n=218

*BRFSS 2010 Health Status and Health Risk Behaviors of Arizonans

n=63

n=10 n=7








Percent Who Could Not Afford Needed Health Care Arizona 2010*

9.6

23.1

11.2

27.4

8.2

0

5

10

15

20

25

30

White, Non-Hispanic



Perc

ent

*BRFSS 2010 Health Status and Health Risk Behaviors of Arizonans

7

Average Cost of Care^

Doctor’s Office vs.

Emergency Room Doctor’s Office $60 Emergency Room $383 ^U.S. average cost of care; Source: Blue Cross and Blue Shield Association http://www.bcbstx.com/employer/hccc/topic6.htm

n=409

n=192

n=43

n=16

n=5








Residents with Personal Doctor Arizona 2010*

0102030405060708090

Perc

ent

United States^

*BRFSS 2010 Health Status and Health Risk Behaviors of Arizonans ^2010 Centers for Disease Control & Prevention, BRFSS Web Enabled Analysis Tool, http://apps.nccd.cdc.gov/s_broker/WEATSQL.exe/weat/index.hsql








Had a Check-up in Past Year Arizona 2010*

0

10

20

30

40

50

60

70

80

Perc

ent

United States^









No Dental Visit in Past Year 2010*

0

10

20

30

40

50

Perc

ent

United States^









Overall Health Status § Arizona 2009*

0%

20%

40%

60%

80%

100%

White, Non-Hispanic

Hispanic American Indian Black Asian/PacificIslander

Perc

ent o

f Ind

icat

ors§

Better ThanAverageAverage

Worse ThanAverage

*2009 Differences in the Health Status Among Race/Ethnic Groups, Arizona Department of Health Services, Bureau of Public Health Statistics, Health Status and Vital Statistics Section §Percent that each racial/ethnic group ranked better than average, average, and worse than average out of 70 total indicators








Age-Adjusted Mortality Rates For All Cancers Arizona 2010*

0

40

80

120

160

200

White, Non-Hispanic

Hispanic American Indian Black Asian/PacificIslander

Deat

hs p

er 1

00,0

00 p

opul

atio

n

*2010 Arizona Health Status and Vital Statistics Report, Arizona Department of Health Services, Bureau of Public Health Statistics, Health Status and Vital Statistics Section








HealthCheck – Well Women*

0

1000

2000

3000

4000

5000

6000

7000

8000

2009 2010 2011

Clin

ical

Pro

cedu

res

Breast Cancer Screening & Diagnostic Services

Mammogram

DiagnosticServices

Clinical BreastExam

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2009 2010 2011

Clin

ical

Pro

cedu

res

Cervical Cancer Screening & Diagnostic Services

Pap Test

HPV Test

DiagnosticServices

*All data provided was collected through the Well Women HealthCheck Program








HealthCheck – Well Women*

0

20

40

60

80

100

120

140

2009 2010 2011

Cerv

ical

Abn

orm

aliti

es

Cervical Abnormalities Diagnosed

InvasiveCervicalCarcinoma

CINIII/ SevereDysplasia/CIS

CINII/ModerateDysplasia

0

20

40

60

80

100

2009 2010 2011

Canc

er C

ases

Breast Cancer Cases Diagnosed

InvasiveBreastCancer

DuctalCarcinoma InSitu (DCIS)

14

*All data provided was collected through the Well Women HealthCheck Program








HealthCheck – Fit at 50

247

812

765

75

227

158

10 1 0

100

200

300

400

500

600

700

800

900

2010 2011 2012*

Serv

ices

Colon Cancer Screening Services

FecalImmunochemicalTestColonoscopy

Fecal Occult BloodTest

Double ContrastBarium Enema

*To date (05/14/2012)

Number of Diagnosed

Colon Cancer Cases

• 2010 0 • 2011 4 • 2012 4








Strategies

• Primary Care Provider Incentives

• Shortage Designations

• Community Development

• Sliding Fee Scale Development

16








Workforce Programs • Provide loan repayment and/or stipend incentives to primary

clinicians working in medically underserved communities – Arizona Loan Repayment Programs – provide incentives for primary

care providers and dentists (urban and rural sites)

– J-1 – allows foreign medical graduates to remain in the U.S. for 3 years

– National Interest Waiver Program – allows certain foreign workers with advanced degrees or exceptional abilities to work in the U.S.

– National Health Service Corps – federal program that provides loan repayment and scholar funding

– Early Childhood Incentives Program (through First Things First) – provides incentives for Speech/Language Pathologists, Occupational Therapists, Child Psychologists, and Mental Health Specialists to provide early childhood development services to children under 5 years of age

17








Workforce Programs

18

Arizona Loan Repayment Sites in Arizona Medically Underserved Areas – March 2012 Fiscal Year 2012:

• 17 providers funded through the Arizona Loan Repayment Programs

• 30 providers for the J-1 Visa Waiver Program per year

• 240 providers obligated with the National Health Service Corps

• 22 providers funded through Early Childhood Incentives Program (FTF)

• 309 total obligated providers in Arizona








Designations • Purpose

– Designations identify areas or populations as having a shortage or need for dental, mental, and primary health care providers/services

• Current Designations – 136 Primary Care Health

Professional Shortage Areas (HPSAs)*

– 143 Dental HPSAs* – 83 Mental Health HPSAs* – 35 Medically Underserved

Areas – 11 Medically Underserved

Populations

19

*Includes facility designations








Community Development

• Purpose – To improve primary health care access and reduce

health disparities by identifying and assisting Arizona medically underserved communities with community development activities such as capacity building and strategic plan development

• Goal – To strengthen and improve primary health care

access for Arizona medically underserved communities

20








Sliding Fee Scale (SFS) Development*

Discounted/sliding fee schedules are a means of addressing the need for equitable charges for services rendered to uninsured individuals. Providers/Clinics must: • Agree to see all patients regardless of ability to pay • Have a policy of non-discrimination in the provision of health care services • Match current Federal Poverty Level (FPL) guidelines • Offer discounted services up to 200% FPL • Charge patients below poverty a nominal fee or not charge them at all • Post signage to notify patients of available SFS resource *Sliding Fee Scale requirements apply to all providers rendering services at site regardless of participation in Arizona Loan Repayment Program

21








Thank You!

To find out more about how you can help improve access to care in Arizona, please visit:

http://www.azdhs.gov/hsd/index.htm

Patricia Tarango [email protected]

Or 602-542-1436







http://www.azdhs.gov/hsd/index.htm

mailto:[email protected]

Documents

Access to Health Care in Arizona · 2018-04-27 · National Interest Waiver Program – allows certain foreign workers with advanced degrees or exceptional abilities to work in the