Su Clinica Familiar

Programs: Su clinica's commitment to a healthy society includes participation in a variety of different programs, as listed here. - patient centered medical home (pcmh) - su clinica familiar has accomplished and is currently a level 3 patient centered medical home at its harlingen, texas; brownsville, texas; raymondville, texas; and santa rosa, texas location. - accountable care organization (aco) - su clinica familiar is engaged in an aco which is characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for its medicare patient population. The aco is accountable to the patients and the third-party payer for the quality, ppropriateness and efficiency of the health care provided. - diabetes prevention program - through the cdc-led national diabetes prevention program (national dpp), public and private organizations will work together to expand the infrastructure for the nationwide delivery of an evidence-based lifestyle change program to prevent or delay onset of type 2 diabetes among adults with pre-diabetes. - hrsa aims (mental health/ substance abuse grant) - the clinic is currently involved in a two-pronged expansion of existing services: 1) expanded mental health services and addition of substance abuse services in willacy county. This effort includes telehealth consultation with contract psychiatrists. 2) expanded capacity for pediatric and adult mental health prevention and treatment services in cameron county. - integrated healthcare improvement su clinica will improve diabetes and co-morbidity outcomes. We will serve a panel of 200 underserved patients, each with 2 or more co-morbidities including diabetes, hypertension, obesity, and depression, with a focus on improving health outcomes. Provide data showing the results for these patients related to the 4 co-morbidities. - delivery system reform incentive payment (dsrip) 1115 waiver the clinic expects that the use of electronic medical records, health information exchange, patient centered medical home and coordination with the hospital will lead to a percentage reduction in the number of adult patients with type 1 or 2 diabetes whose hba1c is above 9. 0%, otherwise known as poor control. - project doc (diabetes and obesity control) - the goal is to create an ecosystem in which the private sector, healthcare, and patients leverage technology and collaborate to change the healthcare model. - hrsa outreach and enrollment program - expand current outreach and enrollment assistance activities and facilitate enrollment of eligible health center patients and service area residents into affordable health insurance coverage through the health insurance marketplaces, medicaid, or the children's health insurance program. - diabetes collaborative - a national program to provide personalized case management services to diabetes patients. - child health insurance program (chip) outreach program - informs low income families on the benefits of enrolling children in the state chip program.