Planned Parenthood Mid-Hudson Valley

New York

In 2008, long before health care reform became a reality, Planned Parenthood Mid-Hudson Valley (PPMHV) had to face its own reality—that its model for delivering family planning services in four counties 90 miles north of New York City had not kept pace with the regional health care marketplace. At that time, PPMHV had eleven health cen­ters, eight of which had less than a full-time schedule. Forty percent of the staff traveled from site to site. At the same time, hospitals and health networks in its service area were buying physician practices and creating efficiencies. A proliferation of modern, well-staffed, and full-service Federally Qualified Health Centers (FQHCs) began to pop up—sometimes literally around the corner from a PPMHV health center.

“If one of our centers was open only on Tuesdays and Thursdays in a small community, our patients began to realize they had options down the street to receive services any day at almost any time, and often as a walk-in patient,” said Ruth-Ellen Blodgett, President and CEO of PPMHV. “In addition, when a full-service site was short-staffed, often we would have to close a smaller site to ensure coverage at the larger, full-time site. We were not reliably and consis­tently accessible to our patients. Over a couple of years, our patient visits began to drop precipitously. We knew we had to do something radical, and very quickly. ”

With the approval of its Board of Directors, PPMHV set out to completely restructure its delivery network based on a strategic decision to provide full-time, full-service family planning in densely populated, high-need areas. Deciding how and where to do this consumed months of senior staff time.

“We engaged in a community assessment unlike anything I’ve been involved with in my 21 years of executive health care leadership,” said Blodgett. “Staff spent several months gathering and analyzing data about our regional health care environment, high-risk populations, emerging and shifting demographics, and most especially about our ‘com­petitors’ including the hours they were open, insurances they accepted and whether they took self-pay and Medicaid patients. We plotted our health centers on Google maps, which showed where similar services were situated in rela­tion to our centers. We overlaid public transportation routes to help us determine accessibility in any new model we developed.”

In the end, PPMHV proposed four options to its Board of Directors. With the Board’s approval, and ultimately that of the New York State Department of Health, the decision was made to downsize from eleven health centers to five over the course of 3 years. This would entail immediately closing four health centers and eventually consolidating four others into two. The communities chosen to house the full-service sites already had existing PPMHV health centers and represented some of the highest-risk communities in New York State. In some cases, the consolidation of sites meant identifying and moving to a new location.

On July 31, 2009, PPMHV closed four of its health centers. All of the staff at those centers was transferred to the remaining seven centers, resulting in five centers being open full-time, including Saturdays and evenings. Before the end of 2010, PPMHV will consolidate two more.

“We closed July 31 and held our breath,” said Blodgett. “We had done all of our assessments and made the best busi­ness decision based on all of our research. But in July 2009, we were seeing 25 percent fewer patients than in July 2008. And July 2008 was down from July 2007. The unknown was, ‘Will our patients come back? Will we attract new patients?’ By the end of the first month under the new model, we had our answer.”

Prior to implementing the new model in August 2009, each of the preceding months had experienced significant losses over the same month of the previous year. At the end of the very first month running the new model, PPMHV stopped losing patients. As of this writing, PPMHV is serving 10 percent more patients in 2010 than it did in 2009.

“We are not only keeping the patients we had, but are attracting new patients all the time. In addition to being open consistently, fully staffed and for longer hours, we made Mondays an all walk-in day. The word is on the street—if you go to PPMHV, they will be there for you,” said Blodgett.

Having a well-crafted communication plan was key to the successful implementation of such a drastic change in the community. “We couldn’t let the community message be ‘PPMHV is closing health centers.’ The reality was that we were expanding services in consolidated sites.”

Letters and phone calls to legislative representatives, key donors, community constituents and patients emphasized “increasing access.” For several weeks before the change, patients were given “goody bags” with condoms and other giveaways along with the locations and phone numbers for the new sites.

“We could not have confidently made such a dramatic proposal to our Board and to the Department of Health with­out the significant community assessment we conducted,” Blodgett concluded. “At least here in the mid-Hudson Valley, less now equals more—more hours of service, more patients accessing those services, better staff satisfaction and retention rates, and a better chance of financial sustainability. It is rewarding to know that the women in our community still choose Planned Parenthood even when they have an abundance of new health care options. We just had to make sure the doors were open whenever they wanted to visit us!”

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National Family Planning & Reproductive Health Association

1025 Vermont Ave. NW, Suite 800, Washington, DC 20005
Phone: 202-293-3114  |  info@nfprha.org

© 2011 National Family Planning & Reproductive Health Association