The University of Rochester experience

To establish a school-based health center, it is more important than ever to plan for financial support for building a practice. It is difficult to get to and stay at the target enrollment for this population since it is ever-changing group of students. Plan for increased numbers of initial assessments since every year at least one-fourth of the enrollees in the program change. Work closely with primary care providers and make it clear in verbal and written communication that there is no intent to disrupt the relationship with the student. Assess risk of the population and attempt to predict utilization of services (number and type of encounters) and determine costs of care. It is also important to find ways to track hospitalizations, emergency room visits and other unscheduled access to care. Since adolescents frequently seek confidential care, parents and providers may be uninformed regarding the actual cost of management of covered lives in a managed care environment.