Promoting CHCs for Affordable, Accessible, and Convenient Care
Community Health Centers (CHCs) are gaining prominence as a means of providing affordable and comprehensive medical care in underserved communities. Unlike emergency or specialty services, these nonprofit local facilities are capable of treating a whole person with ongoing preventative care as well as dental and mental services that together add up to holistically healthy lives. Stimulus funds are being provided to strengthen America’s CHC network, which along with the expansion of medicare and other programs, will have a big impact. Yet there is more work to be done to promote CHCs as a viable measure to save costs and increase health. Policy is still required at both national and state levels, and CHCs themselves have some heavy lifting to do in order to get in line with new directions in healthcare.
Jose Camacho, executive director of the Texas Association of Community Health Centers (TACHC) is an expert in understanding the shift “from volume to value” in healthcare, and is pushing us to acknowledge the larger value of CHCs with payers at the state and national level. CHCs regularly create value by helping people remain healthy. If a center, for example, expands ts downstream. Hospital care is generally much more expensive than CHC treatment. The problem, however, is that it’s harder to quantify the value of healthiness than it is to measure the dollar expense of sickness. Renumeration policies for Medicare and other insurers are not always in line with the holistic health picture.
Defining value happens at both the top and the bottom of the healthcare system. “The government is certainly driving healthcare changes, with Medical Home and bundled payments,” Camacho explains, “but health centers need to band together to negotiate these payments. We haven’t been reumbursed yet for the quality and value we create. Health centers need to show that they’re creating value, they need to quantify it. And payers need to be open to reimbursement for the value we create.”
Hurdles remain to streamlining healthcare costs while maintaining care for individuals, of course, but steps are being taken in the right direction. Among the policy issues is the question of how to define a medically underserved area for the purpose of financing. Camacho was recently appointed by Secretary of Health and Human Services (HHS) Kathleen Sebelius to the Negotiated Rulemaking Committee membership list for the Health Resources and Services Administration’s (HRSA) Health Professional Shortage Area (HPSA) and Medically Underserved Areas/Populations (MUA/P). These definitions have not been amended in a long time, and the committee is working to identify verifiable data sources for correcting the out of date framework.
Luckily, the underlying fact that the CHC model is a highly beneficial part of healthcare delivery appears to be widely accepted. Camacho says that there is bipartisan support for health centers, which have proven to be affordable, accessible, and convenient for patients. Research is available to demonstrate these values, and is underway both for policy implications and to help CHCs which are lagging. As Camacho states, at the end of the day, CHCs are there for people. “We’re building a system that works for the patient. Not for doctors or hospitals, but for the patient.”
How has your local health center affected your well-being?