HOSPITAL/CLINIC UPDATE: Marin Community Clinics

Like many healthcare organizations throughout the country, Marin Community Clinics (MCC) is in a state of transformation. For several months, we have focused a lot of energy on achieving recognition as a patient-centered medical home (PCMH) through the National Committee for Quality Assurance (NCQA), which offers three levels of PCMH recognition. We are proud to announce that we’ve attained PCMH Level 1 status for our San Rafael and Novato clinics, putting us an elite group of healthcare providers and clinics.

The NCQA seal is widely recognized as a symbol of quality, and achieving Level 1 recognition indicates that an organization has attained a high level of quality care and service. We are now applying for Level 1 recognition for our clinics in Greenbrae and at the Marin Health and Wellness Campus in San Rafael, and we are working toward Level 3 recognition (the highest level) for all four locations.

Why would a busy community clinic choose to become a PCMH? Because PCMH transforms the practice from traditional primary care to a model that enhances access and continuity for patients. Within the PCMH framework, there is a partnership between patients, clinicians and staff. Appointments are more readily available, and care is coordinated with outside agencies when needed. There is also dedication to continuous quality improvement, using evidence-based guidelines and shared decision-making between patients and clinicians. The PCMH model requires embracing a patient-centered approach in access, care and continuity. Patients choose a primary care provider and become familiar with the team that shares their care.

The PCMH approach supports our mission to improve the health of our patients and community by providing high quality, cost-effective, culturally sensitive, patient-centered health care. We are on track to complete the application process for Level 3 recognition in June 2014. As part of this effort, we are piloting a patient portal and focusing on continuous improvement in appointment and telephone access.

MCC provides primary care services in pediatrics, adult and family medicine, dental health, behavioral health, obstetrics and gynecology, teen clinics, and pharmacy services. In our efforts to expand patient services, we recently added optometry at our Novato and San Rafael clinics in collaboration with the School of Optometry at UC Berkeley. This service has been incredibly popular for adult and pediatric patients, and in January, optometry services in Novato will grow from two to five days a week.

Another element of transformation is coming from Carebook, a collaborative program with Marin General Hospital intended to improve patient care during transitions from the hospital. Carebook allows nurses, clinicians and social workers to communicate during the discharge process. MCC team members in Greenbrae check Carebook online daily to see who needs a hospital follow-up appointment. Once the follow-up appointment is made for one of our patients, the time and details are communicated back to hospital staff. Three days per week, one of our staff goes to the hospital to ensure that patients know the date and time of the hospital follow-up appointment. As a result, patients benefit from improved continuity of care between Marin General and MCC.

Since its inception over 40 years ago, MCC has been a healthcare provider to thousands of Marin residents with limited options, primarily to patients who are uninsured or are Medi-Cal beneficiaries. With full implementation of the Affordable Care Act in January 2014, many of our patients will have more insurance options. Medi-Cal will also be expanded so that many people who are not currently eligible will qualify for benefits. Many others who are currently uninsured will be able to purchase insurance through the Covered California Health Insurance Marketplace.

Each MCC location has certified educators and enrollment counselors available to help patients make informed decisions about their health insurance coverage and to assist with enrollment. There is a dedicated phone line (415-755-2586) and email (InsuranceHelp@marinclinics.org) for members of the public and patients to request information or to schedule an appointment with the enrollment counselors. Despite disagreements in the federal government, California is moving forward with full implementation of the Affordable Care Act. We are pleased that up to 4,000 of our 31,000 patients will become insured at the start of 2014.

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Dr. Farren, an internist, is medical director for quality improvement at Marin Community Clinics.

Email: Gfarren@marinclinic.org