Care Accessibility Community Diversity Health Opportunity

Care Accessibility Community Diversity Health Opportunity

July 20, 2010Ken Loving, M.D.

Interim Chief Executive OfficerChief Medical Officer

Community Health Centers: The Cornerstone of Care for the

Underserved

Care Accessibility Community Diversity Health Opportunity

• Proud History42 years of improving health in underserved communities and providing local ownership and control of delivery system

• Large national networknearly 18 million people served: 40% uninsured; 37% Medicaid/SCHIP;

63% people of color; 92% low-income individuals

• Record of Achievement cited by IOM, OMB, and GAO for excellence in care, disparities

reduction, cost-effectiveness, and community benefit

• Bipartisan support Congressional majority and key Presidential candidates praise work,

mission of health centers, call for continuation & growth

Community Health Centers Today

Care Accessibility Community Diversity Health Opportunity

Brief History of Health Centers

• Unique Public-Private Partnership: resources directly to community-owned organizations

• Health Centers’ two-fold purpose:

– be agents of care in communities with specific need

– be agents of change, giving communities control of their health care system

Care Accessibility Community Diversity Health Opportunity

NACHC

National Association of Community Health Centers• Provides research-based advocacy for health centers

and their patients. • Educates the public about the mission and value of

health centers.  • Develops alliances with private partners and key

stakeholders for delivery of primary health care services to communities in need.

Care Accessibility Community Diversity Health Opportunity

NACHC’s Vision for the Future

• Grow health centers to become the health care home for 51 million medically

disenfranchised Americans

• Reform health professions training programs to promote primary care careers, diversity, and service in

underserved areas via health centers

• Preserve the Medicaid guarantee of coverage for low-income, elderly & disabled Americans

Care Accessibility Community Diversity Health Opportunity

• Wire every health center for complete health information technology (HIT)

• Lead the way

to a high-performing health system, grounded in primary care

• Play a central role in emergency preparedness

at the local & national levels

NACHC’s Vision for the Future (cont.)

Care Accessibility Community Diversity Health Opportunity

Why is Health Center Growth Needed?

56 Million People Are Medically Disenfranchised

Care Accessibility Community Diversity Health Opportunity

Why Health Centers?

• Costs: – Total patient care costs 41% lower than those served in other settings* – Save up to $18 billion annually for taxpayers and society*

• Access: – Serve people & communities not served by others – Open to all regardless of ability to pay

• Quality: – Quality is equal or superior to other providers**

* Robert Graham Center** George Washington University, August, 2006.

Care Accessibility Community Diversity Health Opportunity

Why Health Centers?

• Full-cost reimbursement from Medicaid• FTCA Coverage• Unique Health Care Home Model• Pharmacy Services (340B)• Sliding Fee Scale

Care Accessibility Community Diversity Health Opportunity

Who Will Staff Future Health Centers?

• A.T. Still Medical & Dental Schools now training future CHC clinicians• National Health Service Corps revisions to give preference to CHCs for NHSC placements• Teaching health centers building on existing models to expand CHC-based teaching

& training of future clinicians• Linkages with training programs expanding use of CHCs as training sites across country

Care Accessibility Community Diversity Health Opportunity

Also Needed: Partnerships with Other Safety Net/Community Providers

• Organize continuum of care for uninsured locally

• Streamline and simplify eligibility rules and enrollment procedures

• Allocate responsibilities for various care levels to maximize effectiveness

• Ensure that uninsured get the care they need within available resources

Care Accessibility Community Diversity Health Opportunity

What Are The Biggest Challenges We Face?

• Growth in UninsuredNow 47M, +2.2M in 2006, many more coming to health

centers daily• Decline in Charity CareCutbacks by private providers squeezed by declining

income• Loss of Medicaid/SCHIP Coverage Citizenship documentation, threat to SCHIP funding• Changing Nature of Insurance Coverage Growing shift to high-deductible/HSA plans that cover little

or no preventive/primary care, causing huge losses for CHCs

Care Accessibility Community Diversity Health Opportunity

Opportunities: Patient Protection and Affordable Care Act (PPACA)

• 11 billion dollars over 5 years• 20 million more patients• 15,000 more providers• 300 million dollars for NHSC• Almost 50 million dollars to support primary care

residencies

Care Accessibility Community Diversity Health Opportunity

Local Initiative-AFFILIATION

• Improve patient care• Enhance educational opportunities• Serve more patients• Develop primary care workforce of the future

Care Accessibility Community Diversity Health Opportunity