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Moving our Mission and Core Values forward at a time of unprecidented change

by Kay Ramachandran, Executive Director

Kay Ramachandran, Executive Director

In 2013, as implementation of the Affordable Care Act (ACA) drew near, health care providers nation-wide had varied opinions on the legislation and the impact it would have on their health care services. Marillac Clinic was no different. For years we have been the primary care medical home for the uninsured and the under insured members of our community.

As we planned for the implementation of the ACA we knew certain things would happen: some of our patients would “move” from their current uninsured status to being covered by Medicaid; some of our patients would fall in and out of Medicaid coverage; some of our patients would go to the Health Exchange and purchase insurance coverage; but there would always be a component of our patients who would not be eligible for any type of coverage.

As an organization we are committed to our mission and committed to the unique health care options we provide to our communities. We feel we provide a valuable and essential service. We felt strongly that hand in hand with this it is prudent and responsible on our part to find a sustainable financial model so that we can ensure that no member of our community who needs us has to go without our health services now and in the future.

Another impetus for our search for a stable financial model was a study conducted in the summer of 2013. Rocky Mountain Health Plans and St. Mary's Hospital engaged JSI Consulting to conduct a study to determine the optimal model for meeting the primary care needs of the low-income population in Mesa County in the context of health care reform. The study results clearly identified the need for increased capacity and access to primary care services for the low income population. It also noted that without a cost effective and sustainable model for health care provision in to the future, disparities in access to care would most certainly grow. Marillac Clinic has always been the safety net health clinic for the low income population. If we had an access issue for low income residents it was our responsibility to make the changes we needed to make in our financial model, service delivery and infrastructure to meet the growing needs of the communities we serve.

We looked at a variety of options for financial sustainability and after much research and discussion we arrived at the decision to explore the option of securing a Federally Qualified Health Center (FQHC) designation. FQHCs are community-based organizations that provide comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status. Thus, they are a critical component of the health care safety net. They are funded by a federal grant and are entitled to several advantages the most important financial advantage being an enhanced reimbursement rate for Medicaid and Medicare.

In early 2014 Marillac Clinic contracted with a consultant to determine whether the clinic should pursue the designation, and if it would be a suitable financial model for the future sustainability of the clinic and whether the financial model would support a steady growth of our primary care services to meet the access issue we were experiencing in our County. Based on the recommendation of the consultant the Board of Directors of Marillac Clinic voted to pursue the FQHC designation. Over the next several months internal work on the requirements the clinic needs to fill to meet the designation will begin. We are natural collaborators and will begin work with our external partners in the community to move towards working for the designation.

Marillac Clinic has had a national reputation for leading and creating innovative solutions in the field of primary health care. We believe the changes brought through the ACA, as well as an application for the FQHC designation, will bring new opportunities for continued innovation. Through it all, our dedication to our mission and our core values will remain strong. This is the foundation for our very being and the basis of all the service we provide. I will continue to share this information about this news as it progresses. We need the continued support of our donors and friends. Much of what we have achieved has been made possible by your strong association with us and we look forward to taking this new and exciting journey with you.

Thank you for your caring spirits and for your love of service.

Kay Ramachandran, Executive Director