Erie Family Health Center

With all the buzz about health care reform, the curious are asking: What does the new law mean for community health centers like Erie?  Some even wonder if the need for community health centers will vanish. In honor of National Public Health Week, Beats Per Minute is breaking down the ins and outs of health care reform and what it will mean for community health centers around the country.

Millions more to seek primary care by 2014

With the ink of President Obama’s signature barely dry on the Patient Protection and Affordable Care Act, a transformation is about to happen over the next decade.  For the first time in our country’s history, there will be a major effort to make health insurance available to almost all Americans – nearly 32 million will be added to the health insurance rolls. 

 

Most community health centers like Erie care for high volumes of patients without insurance (34% at Erie) or covered by Medicaid (62% at Erie). Medicaid is the federal-state partnership to provide health care coverage for those living at the federal poverty level or below.  Starting in 2014, some 16 million more people  will become eligible for Medicaid as the income limits to qualify are raised from 100% of the federal poverty level (about $22,000 per year for a family of 4) to 133% of the federal poverty level (about $30,000 per year for a family of 4). 

Where will 16 million more Americans seek health care?  Community health centers already serve almost 20 million Americans; over a million in Illinois and over 600,000 in the Cook County area.  Located in neighborhoods and towns which are some of the most medically underserved and economically challenged in the country, community health centers are perfectly positioned to expand services. 

Placing a brand new Medicaid card in the hands of millions will not solve the daily challenges people living in poverty face every day:  challenges in literacy, joblessness and lack of transportation.  Although the health care reform bill makes efforts to pay private doctors better for seeing Medicaid-covered patients, many private physicians, private physician groups and university-based practices do not accept or severely limit access for Medicaid patients.  A massive increase will be needed in primary care capacity at the community level. 

Overall, this is good news for community health centers.  Many health center patients who have no health insurance will now be eligible, either for Medicaid or for more affordable insurance through their employer or purchased on their own.  Let’s not forget, that another 16 million Americans will get on the health insurance bus through insurance exchanges, employer-based insurance and other means. 

More bricks and mortar are needed

The health care bill provides $11 billion in new funding for the health center programs over the next five years.  Health centers successfully competing for these funds will be able to expand.  Expect 20 million more people to access high quality, culturally competent behavioral, medical and oral health care at community health centers over the next 10 years – a doubling of the current capacity.

There’s not enough primary care work force

Currently, there simply is not enough primary care doctors and advanced practice nurses to meet the coming demand.  The health care reform bill provides funding for health centers to become teaching centers for the next generation of primary care doctors. Erie is already launching a training program sponsored by Northwestern McGaw Medical Center and Norwegian American Hospital.  Within 3 years, twenty-four family physicians-to-be will be in training at Erie.

Once physicians are trained, they need an incentive to work in medically underserved communities.  Many graduating medical students carry the burden of well over $100,000 in school loans.  The health care bill includes $1.5 billion over the next 5 years to expand the National Health Service Corps, a loan repayment program for doctors who choose to practice in medically underserved areas.  This initiative will place an additional 15,000 primary care doctors, nurse practitioners, dentists, and behavioral health specialists in communities of need.

Will community health centers vanish?

With the demand for primary care services increasing by 32 million over the next decade and low acceptance of Medicaid amongst healthcare providers, the need for community health centers has never been greater.

Push the throttle forward, fasten seat belts and get ready for take-off!

Tags: community health, health care reform, primary care, public health, uninsured