Community Health Centers Essential to Realizing ACA's Coverage, Access Goals

Research Report Lays Out Case for Funding to Maintain, Expand CHCs

May 06, 2014 02:02 pm Michael Laff

Although many are optimistic about the large number of individuals who signed up for health coverage following enactment of the Patient Protection and Affordable Care Act (ACA), simply having insurance does not necessarily increase access to care or improve health outcomes, says a recent research report(

[Doctor examines young girl sitting on mother's lap]

According to the National Association of Community Health Centers (NACHC), 62 million people have little or no access to primary care because of physician shortages in their residential areas. Other factors associated with limited care access are

  • living in a rural area,
  • low-income status and
  • belonging to an ethnic minority.

In its recent report, Access is the Answer: Community Health Centers, Primary Care & the Future of American Health Care, the association states that an overwhelming majority of these 62 million people actually are insured, including 22 percent who are Medicaid beneficiaries and 58 percent who have other insurance.

CHCs Ready to Serve the Underserved

Given their track record of providing high-quality, cost-effective primary care services for nearly five decades, the nation's 9,000-plus community health centers stand ready to connect those 62 million people to the care they need, says the NACHC report.

Story highlights
  • A new report finds that even with health insurance, millions of Americans have limited or no access to primary care.
  • Community health centers help reduce higher costs associated with ER visits and other costly treatment options.
  • The National Association of Community Health Centers is seeking continued federal funding for the centers, which are scheduled to lose their dedicated federal backing in 2016.

"Clearly, Access is the Answer to what plagues the American health care system," the report states. "Expanding access to primary and preventive care improves health and lowers costs, and is the foundation for driving higher quality care."

Consider these facts:

  • Health centers accept a greater number of new Medicaid patients than do other institutions, with 97 percent of the centers reporting that they accept new Medicaid patients, compared with 66 percent of office-based primary care practices.
  • Community health centers save $1,263 per patient each year by reducing the number of patient visits to emergency departments, ambulatory care centers and other more costly treatment sites.
  • The centers generate savings of $24 billion a year across the entire health system, including nearly $7 billion in savings for the federal share of the Medicaid program.

According to NACHC Board Chair Gary Wiltz, M.D., costs associated with the ACA and Medicaid expansion will increase initially, because people who recently obtained insurance but have not yet sought care will enter the health care system.

But the long-term benefits are undeniable, he contends.

"The value of early screening and prevention is tremendous," says Wiltz. "It is hard to quantify. Utilization rates will increase, and we anticipate that. We won't see the benefits immediately, but over time, the health of the population will improve," he asserts.

Continued Funding Is a Must

The ACA established the Health Center Trust Fund to finance the federal health center program, but in fiscal year 2011, Congress voted to slash the fund by $600 million annually. Sequestration further eroded the federal investment in health centers, the report notes. The trust fund is set to expire in 2016, and the program will have to rely only on discretionary funding to continue after that point.

Cuts to Medicaid payments represent another threat to the existence of the health centers. Medicaid represents 38 percent of the revenue that health centers receive for treating patients. About 500,000 Medicaid patients receive care at the health centers each year, but the centers are only collecting about 80 percent of the costs associated with treating these patients.

Small wonder, then, that NACHC is seeking continued federal funding to maintain and expand the reach of community health centers. One of the association's priorities, says Wiltz, is the reauthorization of the trust fund from 2016-2020.

"We are not claiming to be a panacea for all of America's health problems," Wiltz said. "But when we're seeing 22 million patients, we need the resources to see all these people."