Community Health Centers Poised for Expansion

John Commins, for HealthLeaders Media , September 4, 2013

"In our state we estimate it will affect about 400,000 people who would be eligible for Medicaid expansion that are not going to get it," Wiltz says. We are going to try our best to get them into traditional Medicaid and the health insurance exchanges, but it really doesn't make any economic sense let alone moral sense. It is purely politics and philosophy that is operating and it's unfortunate for the people who are suffering and who could benefit."

Wiltz says expanding Medicaid would save money because treating people in community health centers costs a fraction of what it would cost in an emergency room. "On average, a Medicaid patient seen in a health center is $110. That same person in a hospital setting is almost $800. We have demonstrated tremendous savings."

Community health centers have also been caught in the budget battle between the Obama administration and Congress. The Obama administration included $11 billion in the ACA for capital improvements to the 1,128 federally funded community health centers across the nation.

Congress, however, cut funding for health centers by $600 million in 2011. Also, sequestration cuts are expected to cost community health centers about $120 million, which some studies estimate would translate into 900,000 fewer patients served. Community health centers are stutter stepping.

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3 comments on "Community Health Centers Poised for Expansion"

Robert C. Bowman, M.D. (9/12/2013 at 12:23 PM)
Dr. Wiltz faces more adversity as he is in a state ranked 40th in CHC economic impact per person. As with the US design for health spending, most states fall short while 6 states benefit. Six of the top 10 states in CHC economic impact have the top concentrations of physicians and top economic impact from all other sources. Also rural CHCs fail to receive a share based on need - likely due to 1000 rural counties that benefit little by various state and federal designs. Many are simply not aware of CHC, FQHC, or Rural Health Clinics. They suffer most from lowest education, health, and other government spending - by design. They also suffer under pay for performance and highest readmission penalities (1 - 2%) - 14% of the hospitals in these 1000 counties, 9% for rural, 3% of urban hospitals. As 30 - 50% of Critical Access Hospitals close due to new federal recommendations, the strain on rural CHCs will be even greater. We should not have designs that send less spending and close facilities and drive off clinicians where there is least health spending per person and fewest clinicians. Our nation fails to produce the clinicians that will accept the family practice positions of CHCs with MD 7%, DO 17%, NP 25%, and PA 23% found in family practice positions. All including RNs have little primary care or underserved primary care training as well. NACHC has been working with A T Still University for over 16 years to produce the PAs, dentists, and osteopathic physicians needed for CHCs. More is needed. State primary care associations should have MD, DO, NP, PA, and RN students embedded in CHCs for preparation, training, and obligation - all specific to family practice positions where most needed. We need designs for most Americans rather than current designs favoring few.

Todd (9/5/2013 at 11:39 PM)
Its about time you expand. FQHCs got a big windfall from Obamacare. Quit expecting urgent care centers to play the role of PCMH and primary care.

Jeanette Wood (9/4/2013 at 2:43 PM)
I applaud your efforts to expand days and hours to serve our communities. I encourage you to offer access 7 days/week to further reduce the use of emergency rooms for non-emergent conditions.




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