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By Lou Sorendo- Oswego County Business Magazine

While ConnextCare in Pulaski is savoring its golden anniversary in 2019, it is also continuing its evolution as a major force on the regional health care scene.

From an economic development standpoint, ConnextCare features an annual budget of $26 million and employs 240 individuals, making it the 15th largest private employer in Oswego County.

Tricia Peter-Clark, executive vice president and chief operating officer at ConnextCare, said renewed momentum at the organization began to build on May 16, 2018 when the former Northern Oswego County Health Services rebranded to ConnextCare.

Its recent 50th anniversary gala occurred exactly one year later on May 16, 2019.

“The momentum from the time that we rebranded to this point has not stopped; it just continues,” she said. Peter-Clark said the organization is in its prime in terms of the success it has experienced, particularly in the areas of retention of employees and recruiting new, qualified providers.

“A lot of it has to do with the image we hope to portray to the community about being an upscale, high-quality provider for health care in our community. It’s a place where people want to work,” she said.

Peter-Clark said efforts are being made to market its entire network, and not just the concept of a patient having just one provider and one health center.

“Patients literally have 63 providers in 12 systems,” she said.
Efforts are being made to help patients understand that their health records follow them no matter where they are at within the ConnextCare system.

“There’s a benefit in staying with a system that knows your social and family history, allergies, medications that you are on, and what your struggles have been versus going to an urgent care center that might not have the extensive electronic data available that ConnextCare has,” she added.

Peter-Clark said there has been growth in patient visits as people realize they can go where it is convenient at a time that it is convenient.

Big dollar impact: ConnextCare creates a $26 million economic impact in the region.
“One of the things we’re most proud of is the economic vitality we bring to the community,” said Dan Dey, president and CEO of ConnextCare.

“We bring in professionals who earn high salaries as well as employ workers across the entire wage spectrum, and these folks are contributing in terms of taxes and supporting our schools,” he added.

When the then-NOCHSI took over five primary care facilities from OCO and Oswego Health nearly seven years ago, the sites were not at full capacity.

“Now they are at full capacity, because we’ve been able to recruit additional providers, and that generates more economic impact for the community,” Dey said.

There will be five new providers added to the ranks in the summer months.

Since Dey became president and CEO of the organization 12 years ago, a dramatic turnaround has occurred at ConnextCare.

He began with a budget of $6 million; today, that stands at $26 million. There were 85 employees at NOCHSI 12 years ago; that employment figure now is at 240.

When Dey began his leadership role, he had a federal grant of $638,000; today, that grant is for $3 million; the debt load a dozen years ago was $2.4 million; today, the organization is debt free; and 12 years ago, there were zero investments; today, ConnextCare is up to $4 million in retained investment earnings.

He said vital to that success is “getting the best people possible both on the provider and management side.

“It’s a team effort. We have remarkably qualified individuals on the provider side, and have developed a young, energetic, dynamic, and qualified management team that will propel us into the future as well.”

Meeting standards: Dey helps conduct compliance visits to federally qualified health centers like ConnextCare across the country.

“I have probably visited up to 200 other federally qualified health centers throughout the country, and the No. 1 challenge each of those centers has is recruitment of providers and meeting the needs of the community by expanding access,” he said.

“When I compare what we’ve been able to accomplish relative to that, we’ve been extremely successful in terms of our ability to expand access, consolidate our programs and hire highly qualified providers such as physicians, nurse practitioners, physician assistants, dentists and dental hygienists,” Dey said. “We’ve been extraordinarily successful in meeting increased demand, particularly in light of the dearth of primary care physicians that are coming out of residencies.”

In terms of keys to recruiting, Dey said it is all about quality and reputation.

“We’ve established a reputation by providing good, high-quality care, and providers want to be part of a high-quality organization. We have a good reputation, and that reputation is expanding and we’re being more successful in terms of recruiting providers. We have also implemented a culture and atmosphere of balanced family-work life, where we recognize family is important,” he added.

While ConnextCare focuses on primary and preventive medicine, a lot of the focus and funding has been directed toward the ongoing opioid and drug use crisis.

“We’ve been continuing to expand that program, as well as behavioral health and dental,” Dey said.

“Folks consider primary care what they get from their physician, but we provide a whole comprehensive array for the patient’s entire health and well being, and that includes a focus on mental health, substance abuse and dental,” he added.

Expansion mode: ConnextCare’s focus on providing dental and mental health services continues to evolve. The organization received $250,000 in funding through Sen. Patricia Ritchie (R-Heuvelton) efforts in Albany that allows ConnextCare to expand oral health services.

“Our concentration with those dollars is to add oral health services in Oswego as well as to add services at our school-based health center in the Altmar-Parish-Williamstown School District,” Peter-Clark said.

The application for the school-based health center expansion is under review of the state Department of Health, and Peter-Clark said hopes are that the program will be operational in that district this fall.

In regards to its Oswego expansion, ConnextCare originally intended to blend the new facility into its existing primary care site on George Street.

“We realized, however, that we were really maxed on space by adding dental, and we were ultimately compromising what that program could be by trying to make it fit into the mold we already had,” she said.

ConnextCare is now working with community partners to find a new home to move its Oswego office to where it can feature a full-fledged dental, mental health and primary care facility.
ConnextCare used state funds to purchase dental equipment for its Oswego dental site, so it is prepared to equip the site once constructed.

Meanwhile, ConnextCare has been successful in recruiting licensed clinical social workers, and now has three full-time staffers. It also has a psychiatric nurse practitioner as well as a physician assistant who is certified in psychiatry.

Also, ConnextCare uses a contracted psychiatrist through Upstate Medical University, so it has three individuals that concentrate on providing psychiatric services, mostly for adults.

On July 1, ConnextCare is expected to bring on board through contracted services with Upstate a child psychiatrist who will spend one day a week at the Pulaski facility.

Other major development at ConnextCare include:

• Recently, the organization redesigned its behavioral health space and moved it from the basement level of the Pulaski facility upstairs so it can engage and integrate more efficiently with primary care services.

• ConnextCare also has a pending federal application that will allow it to expand substance use services by adding another provider to offer counseling.

• Also, an oral health grant was recently submitted to the Health Resources and Services Administration to allow ConnextCare to renovate its entire Pulaski location and upgrade and expand its existing oral health services.

• Another development is the planned addition of another school-based health center in the Mexico Central School District. It will be located in the elementary school but will also serve the high school. Plans are to be operational in late fall of this year.

• ConnextCare has applied to the New York State Department of Health for the second phase of the statewide Health Care Facility Transformation Program to relocate and expand its Phoenix office, through community partnerships, to include multi-specialty, large capacity medical, dental and mental health services.

Peter-Clark said these programs are all tailored around “what we do best, which is primary care, dental and mental health. That’s really what our focus is, and we’re trying to expand services to continue to support those.”

Federally qualified center: Dey said there are many advantages to being a federally qualified health center.

He said philosophically, “the government supports federally qualified health centers because we are dedicated to providing service in areas that are generally medically underserved.”

“That is their target and focus, and with that comes a recognition that you don’t just provide an appointment to a patient for primary care,” he said.

Dey said as a FQHC, ConnextCare gets additional revenue to provide services to fit a variety of patient needs. The goal is to improve the overall well being of the patient, he added.

With an enhanced rate for Medicare and Medicaid services, ConnextCare is able to feature facilitated enrollers that allows the organization to work with patients to find insurance coverage for them, or provide them with a sliding fee scale discount.

ConnextCare also has referral clerks whose role is to help patients follow up with specialty or ancillary services.

“Enhanced reimbursement from Medicare and Medicaid, as well as a federal grant that is 12% of our budget, allows us to do all those other holistic services that you traditionally don’t get in a doctor-patient relationship,” Dey said.

Malpractice coverage, meanwhile, is covered through the federal tort claim, so the government fully subsidizes costs associated with malpractice and supports providers if there is a claim.

Dey noted ConnextCare also has National Health Service Corps eligibility, allowing providers who work with the organization over a number of years to have their medical school or educational loans forgiven.
“That’s a huge advantage in helping us with recruitment as well,” he said.

ConnextCare also features a pharmacy discount program that allows it to generate revenue by offering discounted pharmaceuticals to patients for prescriptions at a wholesale rate.

Accountability factor: Dey said ConnextCare is highly accountable for the care it provides.
“We do annual reports where we indicate how we progressed on a variety of health and financial indicators, and we are compared against the other 1,300 federally qualified health centers across the country,” he said.

“We are obligated to provide data that demonstrates we are increasing quality of care compared against a whole cohort across the country, so we are constantly monitoring, demonstrating and reporting on the success we are having and increasing our quality indicators and financial indicators as well,” he added.

“There’s been a significant evolution in health care over the last 12 years. I think the biggest emphasis and goal is to develop a program based on value-based payments,” he said. “We’re not just getting paid for each episode of care, but we are literally moving in the direction of getting paid for demonstrating overall improvement of health. The more you demonstrate that health, the more you are rewarded in terms of incentives and dollars for that care.”
Reflecting that effort is ConnextCare combining with four other federally qualified health centers in the area — Syracuse Community Health Center, Family Health Network, Regional Primary Care Network and East Hill Family Medical — to develop an independent provider association, where it works together to contract with managed care companies.

“The goal is to track, demonstrate and report on our outcomes to prove to the insurance companies that they are literally saving money because we are able to manage care in a better way.

We are keeping folks out of the emergency department, in-patient beds and avoiding readmissions by providing care in the right location for them and focusing on prevention,” Dey said.

ConnextCare is also working with its Oswego County colleagues on the Oswego County Integrated Delivery Network, with help from the Oswego County Health Department, Oswego County Department of Social Services, Oswego County Opportunities, Catholic Charities and Farnham Family Services.

The network meets regularly to ensure participating organizations are offering complementary services and directing patients to proper services, which optimizes the care and support services they receive.

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