The demand for health care services among uninsured and underinsured patients continues to outpace the resources of the nation's community health centers (CHCs), leaving millions of these patients without access to basic primary care services. That's one of the main conclusions of a study(www.nachc.com) released by the National Association of Community Health Centers (NACHC) during a March 20 Capitol Hill press conference.
Facilities such as Woodward Health Center, a community health center in Rochester, N.Y., have seen federal funding cuts in the hundreds of millions of dollars in the past fiscal year.
"There are 60 million people in America who don't have a family doctor or a health care home or a regular source of primary care," said Dan Hawkins, director of policy for NACHC, who spoke at the press conference. "That is one out of every five Americans."
CHCs provide care to more than 20 million patients at 8,100 health care delivery sites throughout the United States, serving as a virtual lifeline for millions of low-income Americans.
"Health centers are required to target communities that are 'high-need' in terms of access to care, and they also are required to offer services that break down barriers to care," said Hawkins. Yet, at least one quarter of U.S. counties with the highest need indicators for primary care do not have a health center, according to the NACHC report, Health Wanted: the State of Unmet Need for Primary Health Care in America.
- The demand for basic primary care services among the nation's uninsured and underinsured patients outpaces the resources of community health centers (CHCs), according to a new report released by the National Association of Community Health Centers.
- At least one quarter of U.S. counties with the highest need indicators for primary care do not have a health center, the report states.
- Among counties with the highest proportion of uninsured individuals, half lack a health center, and more than half of counties with the lowest numbers of primary care health professionals do not have a health center.
- The report touts the economic benefits of CHCs in saving the U.S. health care system billions of dollars each year.
"In fact, among those counties with the highest proportion of uninsured individuals, half lack a health center today," said Hawkins, citing findings from the report. "And over half of the counties with the worst rates of primary care provider supply do not have a health center."
Consequently, the report notes, the number of Americans who forgo or delay needed care has nearly doubled in the past 10 years.
Hawkins said health centers "stand ready" to expand, especially after the Patient Protection and Affordable Care Act provided a dedicated stream of money for CHCs in 2010. But in fiscal year 2011, Congress cut the federal health budget allocation for the centers by $600 million. As a result, the federal government was able to fund only 67 out of 810 applications for new health center service sites, effectively denying health care services to millions of patients.
In Arkansas, for example, officials applied for funding for six health center expansions and one new CHC, but none of the requests was funded, said Sip Mouden, M.S., CEO of the Community Health Centers of Arkansas Inc., which represents more than 12 health centers that operate in 75 sites throughout the state.
"We are looking forward to increasing the funding for health centers so that we can expand the number and reach of health centers in our state," said Mouden. "In Arkansas, we have 550,000 people who don't have a medical home. And that is really pitiful."
In the current fiscal year, Congress has allocated $200 million for CHCs from the dedicated funding stream established as part of the Affordable Care Act. This should allow Congress to approve more of the grant applications for CHC expansions, said Hawkins.
The report offers several examples of primary care needs that fall into three categories:
- barriers to care, such as affordability, availability and accessibility
- poor health outcomes, often caused by a lack of preventive screenings and other interventions and
- adverse economic consequences that can be traced back to the use of emergency rooms and hospitals rather than primary care.
Health centers address unmet health care needs by removing barriers to primary care access, thus improving health outcomes and avoiding adverse economic fallout. And all this is accomplished in a "locally directed manner," said Hawkins.
"There is not a health center that was created in Washington or in a state capital," he observed. "Every single health center in America grew out of a felt need from a local community that said, 'We need health care.'"
The report also touts the economic benefits of CHCs, noting, for example, that the centers save the health care system $24 billion a year by enhancing access to health care services and improving the health of patients.
Moreover, the report describes CHCs as an "engine for primary care resources in their communities."
"For example, they are currently the place of employment for 40 percent of all National Health Service Corps(nhsc.hrsa.gov) program participants who receive scholarships or loan repayment to serve in areas needing additional professionals," the report states.
"Additionally, nearly 80 percent of health centers are engaged in training health professionals. Research shows that health center-trained physicians are more than twice as likely as their nonhealth center-trained counterparts to work in an underserved area."