Community health centers: What’s working in the U.S. health care system

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By Tuesday, Aug 15 Viewpoints  1 Comment
Community Health Programs' primary facility on Stockbridge Road in Great Barrington.

As the political leadership in Washington grapples with the grim debate over who will have access to health care in the future and who will not, there is, in fact, good news about health care in the United States. This week, leaders at the local, state and national levels will join communities in celebration of National Health Center Week 2017. Their visits to community health centers and our own strong messages will demonstrate that it is possible to move beyond partisan politics and support community-based health centers’ programs that are vital and effective within the nation’s public health system.

Lia Spiliotes, CEO of Community Health Programs.

Lia Spiliotes, CEO of Community Health Programs.

With its roots in the civil rights movement of the ’60s and ’70s, the community health center movement started more than 50 years ago as a small but bold demonstration project to provide health care in medically underserved areas, and to ensure that no one should face barriers to health care. Today, these federally qualified community health centers, numbering nearly 1,300 in the 50 states and with decades of federal funding support, are the primary medical homes for more than 25 million people in 9,800 rural and urban communities in the U.S. Massachusetts is home to 50 such centers including ours, Community Health Programs, which serves more than 32,000 patients at its Berkshire County practice sites.

Since their inception, health centers have saved lives, reduced and prevented chronic disease in the most challenged of patients, provided patients with affordable options for care and helped countless Americans avoid costly emergency room visits. Community health centers are innovators in treating chronic disease and responding to national health crise, such as the opioid epidemic that kills 78 people in the U.S. every day.

There is little doubt that these health centers contribute to cost savings for the American taxpayer. In fact, health centers like ours save, on average, $2,371 (or 24 percent) in total spending per Medicaid patient when compared to other providers, according to a 2016 study published in the American Journal of Public Health.

In the Berkshires, Community Health Programs continues to serve uninsured and low-income patients but, as word gets out about our quality of care and as private medical practices move under our administrative umbrella, our client and payer mix is diversifying dramatically. Nearly 25 percent of our patients are covered by private commercial insurance, 33 percent are covered by Medicare and 36 percent are Mass Health recipients. Six percent are self-pay with a small percentage covered by veterans’ benefits. To support our mission of providing health care to all, the federal government will provide $3.7 million in 2017 funding, or a critical 23 percent of our budget. Our employment ranks have grown from 150 to 223 in the past year, which means we are an economic engine in our community thanks in part to our federal support.

Community health centers and the people who work with us are problem-solvers who look beyond medical charts to prevent illness. We examine factors that actually cause poor health such as homelessness, lack of nutrition, stress and unemployment. In rural regions like ours, geographical isolation and transportation are added risk factors; our mobile health van rolls regularly to meet and care for many of our isolated neighbors.

Throughout the decades and through bipartisan administrations, Congress has consistently seen the value in growing the federal investment in the health center system of care. But right now, a crisis looms with the scheduled expiration at the end of September of a critical fund that supports the budgets of every health center in the U.S. Congress must act swiftly to extend this funding. Why? Because at a time when efforts to reform the health care system are moving forward with potential risks to our most vulnerable citizens, this is no time to turn our backs on health centers that care for each and every patient. Public investment is critical now more than ever.

Health centers bring a unique and important perspective to the national conversation on health care. We are proud that we can work with lawmakers on both sides of the aisle to strengthen and improve the availability of quality primary care and preventive services to everyone who needs them. Good health begins with an investment in primary care; indeed, advanced nations with generous health care treat health care funding as an investment in health, well being and illness prevention rather than a black hole of costs for sick people. Access to and funding for community health centers is a prescription for the good health of our nation and for our neighbors here in the Berkshires.


Lia Spiliotes is the chief executive officer of Community Health Programs in Great Barrington and serves on the board of the Massachusetts League of Community Health Centers.

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One Comment   Add Comment

  1. Steve Farina says:

    I applaud the work of CHP in our community! Their presence and the services they offer are truly of great benefit to Berkshire County, and I greatly appreciate that they are here if I need them.

    Now for the math observations & questions:
    32,000 clients, 94% are covered by some sort of insurance. $3.7M federal funding is 23% of a $16M budget.
    $3.7M ÷ 32000= $ 115.63, that would be the additional charge per client annually to cover the 3.7 million dollars. It seems that if that charge were properly incurred by the insurance coverage, the federal government grant (I am assuming it is a grant, not counted in Medicare client payments – which is what the article alludes to) then that $116 per client would be reduced to about an additional $7 per year out of pocket for the 32000 clients.
    How cool would it be if the federal government grant was taken out of the equation and this concern was completely removed?
    As a side thought/question- how much does it cost the taxpayer for the federal government to administrate the payment of $3.7M considering the payment of all the federal employees from tax collectors to the various departments who administer it, and covering all those employee benefits including healthcare/health insurance? It is definitely way more than $116. This is an excellent model of inefficiency

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