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The Role of Health Extension in Practice Transformation and Community Health Improvement: Lessons From 5 Case Studies.
- Source :
-
Annals of family medicine [Ann Fam Med] 2019 Aug 12; Vol. 17 (Suppl 1), pp. S67-S72. - Publication Year :
- 2019
-
Abstract
- Passage of the Patient Protection and Affordable Care Act triggered 2 successive grant initiatives from the Agency for Healthcare Research and Quality, allowing for the evolution of health extension models among 20 states, not limited to support for in-clinic primary care practice transformation, but also including a broader concept incorporating technical assistance for practices and their communities to address social determinants of health. Five states stand out in stretching the boundaries of health extension: New Mexico, Oklahoma, Oregon, Colorado, and Washington. Their stories reveal lessons learned regarding the successes and challenges, including the importance of building sustained relationships with practices and community coalitions; of documenting success in broad terms as well as achieving diverse outcomes of meaning to different stakeholders; of understanding that health extension is a function that can be carried out by an individual or group depending on resources; and of being prepared for political struggles over "turf" and ownership of extension. All states saw the need for long-term, sustained fundraising beyond grants in an environment expecting a short-term return on investment, and they were challenged operating in a shifting health system landscape where the creativity and personal relationships built with small primary care practices was hindered when these practices were purchased by larger health delivery systems.<br /> (© 2019 Annals of Family Medicine, Inc.)
- Subjects :
- Colorado
Delivery of Health Care organization & administration
Efficiency, Organizational
Humans
New Mexico
Oklahoma
Oregon
Organizational Case Studies
Patient Protection and Affordable Care Act economics
United States
Washington
Community Health Planning economics
Primary Health Care organization & administration
State Health Plans standards
Total Quality Management methods
Subjects
Details
- Language :
- English
- ISSN :
- 1544-1717
- Volume :
- 17
- Issue :
- Suppl 1
- Database :
- MEDLINE
- Journal :
- Annals of family medicine
- Publication Type :
- Academic Journal
- Accession number :
- 31405879
- Full Text :
- https://doi.org/10.1370/afm.2409