Clinical Initiatives

NACHC currently partners with Primary Care Associations (PCAs), Health Center Controlled Networks (HCCNs), health centers, and other organizations to address key clinical issues facing health centers. Recent projects have been supported by the Health Resources & Services Administration’s Bureau of Primary Health Care, the Centers for Disease Control and Prevention, DentaQuest Foundation, A.T. Still University, the American Academy of Addiction Psychiatry and the Denver Health and Hospital Authority.

In the past year, NACHC has invested over $4.6 million In clinical projects in the health center field, worked with 152 different community health centers in 38 states and with 23 different PCAs and HCCNs. Investing in information technology and quality improvement infrastructure at health centers remains a high priority.

NACHC’s clinical projects are guided by internal and external subject experts and currently include pilot models, proofs of concept, prototypes, and learning communities. View the latest fact sheet on CDC projects.

 

Adult Immunization Cancer Screening Heart Disease and Stroke
Hepatitis B and C Opioids Oral Health
Pediatric Health Postpartum Diabetes Screening

Reproductive Health

Tobacco    

Adult Immunization

NACHC is working to improve the delivery of adult influenza and routine vaccination services and reduce vaccination services disparities among underserved adult populations by increasing implementation of the Standards for Adult Immunization Practice at health centers that currently offer adult vaccination services.

Resources

Adult Immunization Fact Sheet

Strategies to Address Policy Barriers to Adult Immunizations in Federally Qualified Health Centers

 

Cancer Screening

NACHC’s cancer screening projects aim to advance and scale a cancer screening transformation approach developed through previous CDC-funded work to improve colorectal and cervical cancer screening in health centers. This project will synthesize actionable findings from the pilot, develop a technical package for broad use, support implementation, disseminate technical package for national spread, and scale and evaluate implementation experience.

Resource

Cancer Screening Fact Sheet

 

Heart Disease and Stroke

NACHC aims to use a multi-pronged approach to achieve positive impacts on two key Million Hearts® 2022 goals: optimizing care that prevents heart attacks and strokes and improving cardiovascular health outcomes for priority populations. Visit NACHC’s Million Hearts® initiative page for more information.

 

Hepatitis B and C

This project endeavors to advance Hepatitis B and Hepatitis C integration in primary care and implementation of the National Viral Hepatitis Action Plan 2017- 2020.

Resources

Hepatitis B Fact Sheet

Hepatitis C Fact Sheet

 

Opioids

NACHC worked with the CVS Health Foundation to integrate addiction medicine into primary care. “Innovative Approaches for Prescription Drug Abuse Management and Prevention” was a 12-month learning community designed to help health centers build capacity for providing integrated behavioral health services in communities with high incidence of substance use and abuse. There were three cohorts.

Resources

Video, Podcast and Blog post highlighting the work of health centers as part of NACHC learning community

Innovative Approaches for Prescription Drug Abuse Management & Prevention Publication from Cohort 1 and Cohort 2

NACHC and Primary Care Associations Working to Integrate Behavioral Health and Addiction Medicine in Primary Care Fact Sheet

Primary Care Associations and Health Centers Working to Integrate Behavioral Health and Addiction Medicine in Primary Care Fact Sheet

Opioid Response Network Fact Sheet

NACHC Clinical-Focused Addiction Activities Fact Sheet

Documentation & Charge Capture Process: Medication-Assisted Treatment

Business Plan for Medication Assisted Treatment

Recording from March 2018 MAT Coding and Billing Webinar

Oral Health

NACHC is working to ensure the integration of oral health and primary care and to improve access to oral health through partnerships and academic collaborations to build the oral health workforce, the use of subject matter expertise to build oral health capacity, and by profiling innovative models in health centers.

As part of the Agricultural Worker Children Dental Sealant Pilot, NACHC developed a Social Determinants of Health Caries Risk Assessment.

Resource

Oral Health Value-Based Care: The Federally Qualified Health Center (FQHC) Story

  

Pediatric Obesity

In partnership with Healthy Weight Partnership, NACHC is implementing the Mind, Exercise, Nutrition, Do It! (MEND) 7-13 Program with 16 health centers in 5 states. The project aims to improve health outcomes for children aged 7-13 with obesity or who are overweight and at risk for obesity.

Resources

Pediatric Obesity Fact Sheet

COMMIT Project Fact Sheet

Postpartum Diabetes Screening

NACHC is working to build the capacity of health centers to screen, refer, track, and follow-up with women with gestational diabetes mellitus (GDM), including the design of a model to increase postpartum screening and counseling and dissemination of evidence-based prevention and management guidelines. In Year 1, NACHC will design a model and strategy to improve diabetes control among GDM-affected pregnancies by increasing postpartum diabetes screening, increasing postpartum contraception counseling, and building capacity for the use of evidence-based interventions. Years 2-5 of the project, if funded, will focus on implementation and scale.

Resource

Postpartum Diabetes Screening Fact Sheet

Reproductive Health

Current projects aim to advance contraception practice guideline adoption in health centers and support providers in facilitating patient-centered care and making evidence-based decisions, leading to improved access to and use of contraception and lower rates of unintended pregnancy. Methods will include validation of current quality measures to look at the ways that contraceptive care is being delivered at community health centers and enhancing access to current contraception practice guidelines by providers and their teams.

Resources

Documentation & Change Capture Process: LARC Services

Contraceptive Practice Guidelines Fact Sheet

Advancing Quality Family Planning Practices: A Guide For Health Centers provides guidance to health centers wishing to expand and improve access to quality family planning and reproductive health services in their community.

 

Tobacco Cessation

NACHC is working to adapt the Million Hearts®’ Tobacco Cessation Change Package (TCCP), specifically for health centers. The main “lesson learned” during this pilot was that multi-disciplinary strategies are most successful. Health centers have assets in the dental, pharmacy, and behavioral health departments that make perfect partners in tobacco cessation efforts.

Resources

Tobacco Cessation Fact Sheet 

Tobacco Cessation Resource Guide for Health Centers

Multidisciplinary Model for Tobacco Cessation

Tobacco Cessation Patient Case Study

Reimbursement Tips: FQHC Requirements for Tobacco Cessation Counseling


Past Clinical Initiatives

Food Insecurity LGBT Health

 

Food Insecurity

Community Health Centers as Food Oasis Partners: Addressing Food Insecurity for Patients and Communities

NACHC, with support from the Medtronic Foundation, completed a project on food insecurity, the state of being without reliable access to a sufficient quantity of affordable nutritious food. The Community Health Centers as Food Oasis Partners: Addressing Food Insecurity for Patients and Communities project sought to understand the depth and breadth of what health centers do every day to assure their patients and communities have access to nutritious food.

The project aimed to gain insight into innovative and promising practices, to collect and share examples of program designs that are replicable and sustainable and to understand ways in which food security interventions are impacting health outcomes in target populations.

Publication

The Community Health Centers as Food Oasis Partners: Addressing Food Insecurity for Patients and Communities report summarizes the findings of the Community Health Centers as Food Oasis Partners project. Explore selected sections below or download the full publication.

Health Center Case Studies

Key stakeholders from 14 diverse community health centers share replicable and sustainable promising practices

Food Oasis Partners At a Glance

Information about local, regional and national organizations involved in addressing food insecurity

Getting Started with Your Own Food Insecurity Program

Recommendations for health centers that wish to take steps to address food insecurity in their communities

Reflections and Recommendations from Health Centers

Words of wisdom from health centers addressing food insecurity as an integrated part of their primary care services

NACHC Food Oasis Glossary

Definitions for common terms related to food insecurity

Video

Health Centers Fighting Food Insecurity

https://www.youtube.com/watch?v=o9OrcjNgeQg&t=2s

This nine-minute video features the patients and staff of Community Health Service Agency, Inc., in Greenville, Texas; Mountain Comprehensive Health Corporation in Whitesburg, Kentucky; and Native Health in Phoenix, Arizona.

Podcasts

This three-part podcast series explores the food insecurity programs at Brockton Neighborhood Health Center in Brockton, Massachusetts; Native Health in Phoenix, Arizona; and Bread for the City in Washington, D.C.

Health Centers and Food Insecurity #1

Health Centers and Food Insecurity #2

Health Centers and Food Insecurity #3

Additional Resources

This report reviews existing and emerging opportunities to document food insecurity screening, assessment, intervention, and billing for each part of a patient visit using discrete codes and language from standardized EHR medical vocabularies.

 

LGBT Health

NACHC and partners supported 10 health centers in 9 states working on improving health outcomes for their LGBT patients. Health center quality improvement teams participated in a practice improvement collaborative, and each health center had a provider champion attend a bi-weekly Project ECHO meeting focused on LGBT health. Much of the work included training staff to provide clinically appropriate, culturally responsible care, creating a physical environment that is welcoming to all patients including LGBT patients, collecting patient sexual orientation and gender identity data, and engaging patients in conversations about their sexual health.

Resource

The Transforming Primary Care for LGBT People Toolkit compiles promising practices around identifying LGBT patients and engaging LGBT patients in culturally responsible, clinically competent care. Priority interventions are supported with implementation tips, tools, and resources.