We Put the Buck in Bucking the Trend

Earlier this month, our President and CEO, Raul Garza, shared exciting news coming out of the latest report on health center cost and quality. Looking at the data for calendar year 2021Aunt Martha’s now has the lowest cost of care among Illinois’ 45 Federally Qualified Health Centers (FQHCs).

But what does that mean, exactly? How far have we come? How low can we go?

Only time will tell, but for now…

What’s happening with health care costs at Illinois health centers?

Over the past seven years, health centers nationally (there are almost 1,400) have seen their Cost Per Patient rise, on average, by 47% – from $827 per patient in 2015 to $1,219 per patient in 2021.

In Illinois, health center costs have skyrocketed at an even greater rate, from $629 in 2015 to $977 per patient last year. That’s an average increase of 53%.

What’s happening with health care costs at Aunt Martha’s?

Since 2015, the cost of care has increased – on average – by $392 nationally and $338 per patient in Illinois. That’s happening at community health centers with a target population that includes those with little and often no income.

Something’s not right.

Then there’s Aunt Martha’s.

At Aunt Martha’s, we made it a strategic priority to drive down the cost of care.

How’d we do? We think the infographic below speaks for itself, but here’s a quick summary:

Since 2019, we’ve lowered our costs by $112 per patient. Aunt Martha’s Cost Per Patient is 41% lower than health centers in Illinois.

Since 2015 – while the cost of care at safety net clinics has gone up by nearly 50% – Aunt Martha’s has achieved its goal of driving down the cost of care by almost 20%.

Community Health Quality Recognition badge, Health center quality leader, gold status, 2022 awardee

As a Federally Qualified Health Center (FQHC), Aunt Martha’s receives programmatic and funding support from our primary funder, the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA). Each year, HRSA compiles data from every FQHC across the country and releases an extensive report detailing, among other things, each FQHC’s performance on core quality metrics and its cost of care per patient.

With every new HRSA report, Aunt Martha’s gains a greater understanding of our position in the community health center space and, more importantly, the value that we bring to our patients, communities, funders, and ultimately the taxpayers. As many of you are already aware, Aunt Martha’s considers value to be at the core of everything we do. It is the lens through which we assess our services. It is what drives our decision making. And it is the promise me make – and keep – for the benefit of those we serve. That is why we are honored to announce that, based on the HRSA report released earlier this week,

Aunt Martha’s ranks #3 in quality as compared to all FQHCs in Illinois.*

Our quality outcomes indicate that HRSA will also likely announce in the coming weeks that Aunt Martha’s is a National Quality Leader for the 7th straight year. While Aunt Martha’s is extremely proud of the quality outcomes we have been able to achieve for some of the most vulnerable, underserved patients in our communities, we understand that quality is only part of the equation. At Aunt Martha’s, we believe that in order to determine the true value of the care we provide, the cost of that care must also be considered.

That is why Aunt Martha’s is also honored to announce we were able to provide those high quality outcomes at the lowest cost of care in Illinois. Aunt Martha’s cost of care per patient is a mere $572 while the average cost in Illinois is almost double at $977. In fact, Aunt Martha’s cost of care has remained lower than the average cost of care in Illinois for the past six years in a row. While the cost of care has increased by 47% nationally and 53% in Illinois over the past 7 years, Aunt Martha’s has decreased our cost of care by 18%. We contribute this success not only our fully integrated approach to care, but also to our comprehensive in-house care coordination services, which allow us to tailor our efforts to the needs of our patients.

When you combine both quality and cost data, they tell a powerful story. From a healthcare perspective, Value = Outcomes/Cost. Therefore, the question becomes, “Are our patients getting healthier and are we lowering the cost of care?” This latest HRSA report unequivocally answers this all-important question. Simply put,

Aunt Martha’s provides the best value of any FQHC in Illinois.

Over the past 50 years, Aunt Martha’s has remained devoted to our mission. We have proudly served our communities with a strong commitment to quality. That is the fabric of who Aunt Martha’s is and will always be. In many ways, the data shows the benefits of our investments in technology, our embrace of both business and healthcare science, and our endless pursuit of innovation. From our adoption of an integrated approach to care 19 years ago to our status as the first FQHC in Illinois to pilot tele-psychiatry 15 years ago, Aunt Martha’s prides itself on leading the way.

To our dedicated staff, I want to thank you for your passion for the work and your commitment to our patients. These outcomes demonstrate that we are on the right path – a path that we will continue to forge as we remain steadfast in enhancing and evolving our model to meet the needs of our patients. To our friends and stakeholders, thank you for joining Aunt Martha’s on this exciting journey – for the past 50 years and for years to come. We know that with days like today, the best is yet to come.

*Based on the compilation of quartile rankings for all quality metrics for each FQHC.

Last Wednesday evening, Aunt Martha’s hosted many of the agency’s closest friends and strongest supporters at our 49th Anniversary Fundraiser event. We welcomed friends from: Iowa and Indiana; from communities across central and northern Illinois like Champaign, Bourbonnais, Joliet and Berwyn; from Peoria to Rockford, from Frankfort to Wilmette; and from all around Chicago – from the far South Side to Hyde Park, the South Loop and Downtown, to Logan Square, Humboldt Park, to the West Side and to the North Side.

For some the event was an introduction to Aunt Martha’s. For others, it was a reminder of what sets us apart. From my perspective, it was important that each of our guests, and you, know that the agency you turn to, partner with and support is committed to being the very best at what we do.

In fact, we learned this month that Aunt Martha’s has been recognized for the 5th straight year as a National Quality Leader. We’re proud of that work, and we’re proud of the people and organizations we work alongside. We’ve worked hard and been fortunate to find partners who share our vision. And we have worked hard to find partners who share our commitment to value.

Value. This is how we judge ourselves. This is what our integrated model is designed to create, by:

Enabling care teams to work together to achieve top quartile quality outcomes; and,

Driving down the cost of care – so much, in fact, that in calendar year 2020 Aunt Martha’s cost per patient was close to 50% lower than the national average (for health centers).

Ultimately, the event was it was an opportunity to share the story of our employees – their hard work, heart and heroism. But my words were not the only ones our guests heard. We also shared a new video with them, which I am proud to share with you today.

Please take a few minutes to watch. It is both a tribute and a renewed call to action. It reminds us how far we’ve come in 49 years, and it offers a glimpse ahead – to the next leg of our journey, to the hard work will do together as we write the next chapter of Aunt Martha’s story. And of our own.

Earlier this month – as I told our employees during a virtual, all-staff gathering last Friday –Aunt Martha’s was proud to join with the 1,370+ Federally Qualified Health Centers (FQHCs) across the country to recognize National Health Center Week. August is also when our primary federal funder, the Health Resources and Services Administration (HRSA), typically releases the latest quality, cost and impact data for every community health center in the country. The recent release of information for calendar year 2020, a preliminary analysis reveals, gives a new layer of depth to the already rich story of Aunt Martha’s work during the most difficult of years.

The information HRSA makes available draws on a core set of information which all FQHCs are required to report, including data on patient characteristics, services provided, clinical processes and health outcomes, patients’ use of services, staffing, costs, and revenues. With each year’s release, we gain a greater understanding of Aunt Martha’s position in the community health center space. 20 years ago, we were a health care start up, if not an upstart as well. Today the data shows Aunt Martha’s is a leader.

A Leader in Access

2020 data shows sustained access to care at Aunt Martha's health centers throughout 2020

Sustained access to in-person, virtual care

Aunt Martha’s is a leader in ACCESS, growing our reach by investing in new communities and reinvesting in those we’ve long been privileged to serve. In 2020, over 12,000 patients visited one of our health centers for the first time. With all but one exception – Aunt Martha’s – no health center in Illinois with a reach comparable to ours (>55,000 patients) achieved more than 2% growth in 2020.

Ramping up telehealth services

Enabled by our rapid transition to a telehealth model, Aunt Martha’s health center staff pushed through the pandemic to keep our patients connected to their medical home and achieve 20% year-over-year growth.

A National Quality Leader

2020 data shows sustained high quality care at Aunt Martha's clinics

Sustained quality a testament to employee commitment

Aunt Martha’s is also a leader in QUALITY. Dr. Charles Barron, our Chief Medical Officer, and his team have worked incredibly hard to turn consistent improvement into sustained excellence. We have now another year’s evidence of the impact of their work as reflected in HRSA’s Health Center Adjusted Quartile Rankings, which illustrate Aunt Martha’s standing compared to other health centers after controlling for certain differences (e.g., patient insurance status, community demographics) that can influence performance outcomes.

In 2019, Aunt Martha’s average quartile quality score made us #13 overall among all of Illinois’ 45 FQHCs, and #5 among those which reported on the same clinical quality measures. Despite the pandemic, and despite a simultaneous period of rapid transition and growth, our health center staff rose to the occasion and delivered exceptional care. We are today, by comparison, ranked #7 for quality among all of the state’s FQHCs and #2 among our closest peer organizations.

Focused on Value

And Aunt Martha’s is a leader in VALUE. This begins with the medical home, the relationship between our patients and their care teams, and with Aunt Martha’s integrated model of care. It is a model designed to maximize the impact of every member of the care team and drive down the cost of care. Over the period of the last 6 years, our focus on integration, quality and efficiency has helped us drive down our cost per patient by 15%.That’s a stark contrast to trends at both the state and national levels, where FQHCs have reported cost increases of 40% and 26%, respectively.

Looking more closely at the value of community health care

To more fully capture the impact of that effort, our analysis included the creation of a composite Value Score to represent, overall, a health center’s quality and cost. This metric distills the essence of value-based care to a single figure. It accounts for the breadth of the scope of a health center’s services, as well as the complexities of the people and  communities it serves; and, when complete, the calculations place Aunt Martha’s at or near the top of any list of value creators in Illinois, if not nationally. That is a space we are proud to occupy.

Access. Quality. Value. This is our work. This is our story. Thank you for sharing it.

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