Morris Heights Health Center: Verona Greenland, CEO

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New York’s Southwest Bronx is known for many things, diversity being one of them. The community is rich with Hispanic, West African and Bangladeshi culture, among other nationalities. Unfortunately, this socially challenged neighborhood of low-income residents is also known for its occurrences of heart disease, diabetes, asthma, obesity, hypertension, cancer and HIV/AIDS among its residents.

Verona Greenland, CEO and a founder of Morris Heights Health Center, believes strongly in providing quality healthcare services to everyone, regardless of their economic standing.

“There’s often the perception that because you’re located in a lower-income community that the quality of care needs to be substandard,” she said. “We don’t subscribe to that concept. We believe that everyone requires the best quality care that is possible.”

Morris Heights is a 30-year-old non-profit primary care health center located in the Southwest Bronx. The center employs about 400 people and maintains an operating budget of approximately $40 million. Greenland describes the health center as a “one-stop” provider of comprehensive primary health care services( adult medicine, pediatrics, OB/GYN services, mental health services, family health care and HIV/AIDS services) The center also addresses women’s health needs, from prenatal care through labor and delivery, and the CEO is proud of its accomplishments in healthcare for women.

“We also have one of the first out of hospital birthing centers in the country located in a low-income community,” she said. “Morris Heights generates  about 800 deliveries annually, though the majority is delivered at the surrounding  hospitals.”

Unique Culture

Just as the community’s demographic is very eclectic, Greenland works to replicate that makeup within the walls of her facility.

“We are committed  to make sure that we recruit capable individuals who contribute to  the unique atmosphere of our health center,” she said. “Having an   environment that is reflective and supportive of our community  is one of our core values ”

Financial Challenges

Like all healthcare facilities, the current economic downturn presents Morris Heights with a major challenge. More and more patients are losing health insurance coverage, which means the portion of uninsured patients continues to escalate. As a facility that receives federal funding, Morris Heights must provide care to all, regardless of ability to pay, as one of its mandates. Given the health center’s demographics, public insurance is the insurer they see the most. With reimbursement oftentimes insufficient to support the true costs of providing these services and with competition for grants increasing, they work tirelessly  to secure funds to underwrite the cost of providing care to all, Greenland said.

“The grants that we would normally receive are continuing to diminish,” she said. “Even though the grants are diminishing, the needs and the demand for services continue to escalate. We’re in a catch-22 situation – the need is here and the demand is here but oftentimes we don’t have the resources.”

Greenland stressed, however, that there’s more to running a facility like Morris Heights Health Center than finances. It is about commitment, passion and a willingness to do whatever it takes,  without compromising  the organization’s integrity, to improve the quality of life and the health and well-being  of the  people served.

Coverage for Holistic Treatment

Morris Heights’ patients present themselves at the health center with far more social issues than the average population. Because of that, the CEO said, it is imperative to maintain a model of care that can treat the entire human being. It is the health center’s responsibility to plan for the type of care necessary for individual patients, indirectly and directly.

Compliance with treatment recommendations is an issue with which we grapple “often patients do not go for needed specialty services for a host of reasons. This undermines the  efficacy of care we deliver. This is pattern of care utilization presents unique challenges for the providers who must find innovative ways to combat this behavior.

Greenland explained that the act of seeking medical care within the communities surrounding Morris Heights is  not as compartmentalized as it is in more upper-class and upper-middle class environments, where individuals have the latitude to seek a variety of medical specialties because their insurance allows them to obtain the care they need. In these communities, providers must strive to provide as much care and address as many health and social issues as possible in the few minutes that patients allow for care.  The primary care provider, by force of circumstances, has to incorporate and offer as many needed subspecialties as they can within their model of care.

“Many of our services are intrinsic to promoting health and the prevention of disease. They are effective and save lives and money but, unfortunately, they aren’t highly regarded services even among members of  the medical community” she said. “There are services that we perform that should be reimbursed but oftentimes are not. Because of the populations we serve, we believe that we have a moral obligation to treat them holistically even when it isn’t financially expedient.

Managed Care

The managed care environment is going in many, sometimes conflicting directions, Greenland said. For example, reimbursement is often lower under managed care but access to subspecialties is greatly increased and this has served to level the access to care playing field, particularly for people covered by public insurance. However, in the case of Morris Heights, which works with 21 separate managed care plans, this requires a labor-intensive effort to work within the bureaucracy while leveraging the benefits to be found in managed care.

“You have physicians addressing paperwork instead of taking care of their patients,” she said.

IT Upgrades

Morris Heights is looking to make capital investments in its IT infrastructure to become more interoperable, Greenland said. The health center will have a  fully implemented electronic patient health records system by January 2010 and will update all its computer systems so that “technology can become the driver of the organization.”

Additional IT investments at Morris Heights will  include the development and implementation of an effective patient practice management system, a human resource management system as well as  accounting and payroll systems; all of which are transforming the organization.

“We’re moving from a manual organization to becoming more automated and data driven,” Greenland said. This will  help us to become more effective and more efficient while improving the  quality of services as  we reduce costs.”

Continued Advancements

Morris Heights is also looking at a major investment in overall quality of care, with an emphasis on evidence-based practice. Greenland said this is important when considering some of the medical conditions prevalent in the communities served by Morris Heights – obesity, HIV, hypertension and asthma.

“As health care providers in the Southwest Bronx, our goal is to make sure we can continue to positively impact and reduce the health care disparities that are prevalent in communities like ours,” she said.

-by Kathy Knaub-Hardy

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