by
Loren Bonner, DOTmed News Online Editor | March 31, 2014
From the March 2014 issue of HealthCare Business News magazine
Community health centers’ fundamental identity as safety net providers is likely to remain in place under the Affordable Care Act, but the law does envision them in a broader capacity as the backbone of the health care delivery system due to newly insured patients, many of them Medicaid patients.
“The expectation is that community health centers will double the patients they serve,” says Sandman.
Growth comes in many forms
Community health centers receive federal grant money in addition to funds they receive from public and private payors, which normally isn’t that much.
“Federal grant dollars act as a kind of last dollar pull for people who are uninsured,” says Dan Hawkins, senior vice president of public policy and research at the National Association of Community Health Centers.
Today, there are more than nine thousand community health center sites across the country. They are in every state and serve roughly 23 million people.
Despite the bipartisan support community health centers have received through the years, funding is always at stake. Under the Bush administration, community health centers grew from serving nine million to 18 million patients. President Bush admired what health centers represented and also saw them as one way to take the pressure off of hospital emergency rooms. The program was doubled again in 2010 through $11 billion in pre-appropriated, or guaranteed funding, in the ACA. But Congress has taken back one-third of that money in what Hawkins says is “not an anti-community health center vote, but an anti-Obamacare vote.” Most recently, a bill was approved to fund the government through this fiscal year that included 7 hundred million in new funding for community health centers. An even larger increase will occur in 2015, with a projected growth figure of serving 35 million patients by the end of that year.
Many community health centers have expanded by adding new sites of care in neighborhoods with a growing need. Others have renovated their existing buildings, or added more staff and services.
“The focus has always been on primary care but because there is often a gap in specialty care, some health centers have brought specialty services to their sites either by contracting with a physician or hiring one,” says Laurie Felland, senior health researcher at Mathematica, a policy research institute, who with her colleagues has been tracking health centers in 12 communities across the U.S. since 1995.
Delivering basic, primary health care and preventative medicine was the initial function of Medicaid. However, with the service being the sole health care option for many, some community health centers have experimented with ways to expand its role to offer specialty care as well. In addition to having specialists deliver care at a community health center site, sometimes it’s just a matter of making sure staff coordinates care for patients. Many community health centers see the demand for specialty care becoming more of an issue due to the coverage expansion under the law.
