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Access to Care and the Economic Impact of Community Health Centers

Access to Care and the Economic Impact of Community Health Centers. National Congress on the Un and Underinsured Monday, December 10, 2007 3:30 - 4:30 . The Robert Graham Center. Community Health Centers. What are health centers? Whom do they serve?

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Access to Care and the Economic Impact of Community Health Centers

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  1. Access to Care and the Economic Impact of Community Health Centers National Congress on the Un and Underinsured Monday, December 10, 2007 3:30 - 4:30 The Robert Graham Center

  2. Community Health Centers • What are health centers? • Whom do they serve? • How do health centers overcome barriers to care? • How do health centers make a difference? • Why is investing in health centers important?

  3. Health Centers: History and Purpose • Founded in 1965, through civil rights & war on poverty movements to address needs of poor & minorities • Two-fold purpose – • Be Agents of Care in areas with too little of same • Be Agents of Change, giving communities a role • Today: 1150 Health Center organizations • Located in every state and territory • More than 6,300 health care delivery sites, 600 of them school-based, plus additional mobile clinic, shelter, and labor camp sites

  4. Health Centers Today • Health care home for over 17 million Americans • 1 of 5 Low-income Uninsured Persons • 1 of 8 Medicaid/CHIP Recipients • 1 of 4 Low-Income, Minority Individuals • 1 of 5 Low-Income, Uninsured Individuals • 1 of 9 Rural Americans • 923,400 Farmworkers, 940,000 Homeless Persons

  5. Overcoming Barriers to Care • Key features of health centers: • Location in high-need areas • Open to everyone regardless of ability to pay • Offer comprehensivehealth and related services (especially ‘enabling’ services) • Tailor services to meet specific community needs (HIV, mental health, linguistic/cultural appropriateness) • Governed by community boards,to assure responsiveness to local needs

  6. How Health Centers Make a Difference • Independent evaluations of centers find: • Excellent Quality of Care: More Effective Care, Better Use of Preventive Care, Fewer Infant Deaths • Major Impact on Minority Health: Significant Reductions in Disparities for Health Outcomes, Receipt of Preventive and Condition-Related Care • Higher Cost-Effectiveness: Lower Overall Costs, Lower Specialty Referrals and Hospital Admissions, Substantial Medicaid Savings • Significant Community Impact: Employment and Economic Effects, Contribution to Community Well-Being, Development of Community Leaders

  7. The Access for All America Plan • Grow health centers program to serve 30 million people by 2015 by – • Developing new CHC sites and expanding existing sites • Funding every health center for oral and mental health, and for pharmacy services • Increasing workforce training programs (especially NHSC) to build primary care workforce for all • Increasing support for new facilities, equipment, HIT, and quality/performance improvement • Maintaining Medicaid and SCHIP coverage, and expanding it wherever possible

  8. Who and How Many Need Care • Americans of all income levels, race and ethnicity, and insurance status have inadequate access to a primary care physician • 56 million Americas are “medically disenfranchised”

  9. No Usual Source of Care • Nearly 1 in 5 (19.3%) Americans (55.5 million people) reported lacking a Usual Source of Care –same as our medically disenfranchised number; • Of those without a USC, 32% are uninsured and 21% are low income; • 52% of all uninsured people under 65 years of age have no USC; • Nearly a quarter (24%) of all poor or near-poor are without a USC; and • 32% of all Hispanic or Latino Americans have no USC • 23% of all Black,non-Hispanic people have no USC Source: 2004 Medical Expenditure Panel Survey

  10. Map 1 Percent of Medically Disenfranchised By State, 2005 DE DC 40% or greater 20 - 39.9% 19.9 -10% Less than 9.9% National Average = 19.4% Note: Does not subtract health center patients as state and U.S. medically disenfranchised figures do. Source: The Robert Graham Center. Health Services and Resource Administration (HPSA, MUA/MUP data, 2005 Uniform Data System), 2006 AMA Masterfile, Census Bureau 2005 population estimates, NACHC 2006 survey of non-federally funded health centers.

  11. No State is Immune • 21 States each have more than one million medically disenfranchised residents. • Florida, Texas, and California together make up 29% of the 56 million • 2 in 5 residents in nine states have threatened or limited access to basic health care. • 55.9% of Alabama residents are medically disenfranchised.

  12. The Primary Care Payoff • American currently spends $2 trillion health care. • Health centers generate substantial savings • Americans could potentially save the health care system $67 billion.

  13. CHCs and Hospitalizations • Average annual cost reduction of $1,810 (median reduction ($959) = 41% reduction • Average annual cost reduction for Medicaid $996 (median reduction $399) Source: 2004 Medical Expenditure Panel Survey

  14. CHCs and ED visits • For Medicaid beneficiaries, 35.5% relative reduction in ED visits • 37% reduction for Blacks • CHCs may facilitate more appropriate ED use for uninsured and poor Source: 2004 Medical Expenditure Panel Survey

  15. Health Center Savings • Health Centers generate between $9.9 and $17.6 billion. • By 2015, health centers would generate at least $22.6 billion, and as much as $40.4 billion.

  16. Health Center Economic Benefits • Impact on predominantly low-income communities served: • Health center spending that flows to/through communities • Employment of local residents • Businesses in community that benefit from health center’s presence (directly and indirectly)

  17. Methods • IMPLAN (Impact analysis for PLANning) – complete economic planning tool. • IMPLAN’s output, earnings, and employment figures are aggregated based on the following: • Direct effects • Indirect effects • Induced effects

  18. Table 1Total Economic Activity Stimulated by Federally-Funded Community Health Centers’ Operations, 2005

  19. Table 2Total Economic Activity Stimulated by an Average Large Urban and Small Rural Health Center, 2005

  20. Table 3Health Center Economic Impact by State, 2005

  21. Future Impact • Federally qualified health centers could serve 30 million patients by 2015. • The estimated operating expenditures is $23.5 billion. • Projected expenditures - an estimated total economic impact of $40.7 billion. • Creating more than 460,000 full time equivalent jobs in 2015.

  22. Challenges Ahead • Expansion • Investment • Workforce

  23. For More Information Contact: Dan Hawkins dhawkins@nachc.com Bob Phillips bphillips@aafp.org Falayi Adu fadu@caplink.org View Both Access Denied and Access Granted at: www.nachc.com/research

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