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