With health reform in the works, the importance of community health centers is growing, according to the authors of a study recently published in the New England Journal of Medicine.
As a close relative to the patient centered medical home (PCMH), the CHC model of care is seen as one way to reform primary care across the country and fix the physician shortage.
“They have always been, since their inception, appreciated by both parties in Congress. They have enjoyed bipartisan support and that of the medical community for a long time,” said Eli Adashi, professor of medical science at Brown University and lead author of the study “Health Care Reform and Primary Care – The Growing Importance of the Community Health Center.”
The Patient Protection and Affordable Care Act underwrites CHCs and enables them to serve nearly 20 million new patients while adding an estimated 15,000 providers to their staffs by 2015, according to the study.
CHCs “could serve several roles; they are important primary care portals to everybody, including the 32 million newly insured Americans,” Adashi said. “They will also continue to serve as a safety net provider to many people in need of care … and as one of the models that could be considered as a primary care delivery system.”
CHCs were introduced in 1965 by the Office of Economic Opportunity as a component of then-President Lyndon Johnson’s War on Poverty, but have received very little attention since then.
“They may not be broadly known about by the lay population, or even the medical community,” said Adashi. “They were already of some substantial size and scope and we’re now about to go beyond that because of the healthcare reform bill.”
Funds have been made available through the American Recovery and Reinvestment Act to help improve and sustain CHCs. A year ago, First Lady Michelle Obama announced $851 billion in funding to “address the immediate and pressing health center facility and equipment needs and increase access to healthcare for millions of Americans.”
“Community health centers provide care to the Americans who need it most and their work has never been more important,” she said.
“Community health centers, by design, provide quite a bit of support for their patients given their unique needs,” said Michael S. Barr, MD, vice president of the practice advocacy and improvement division of governmental affairs and public policy for the American College of Physicians. “CHCs are now receiving funding to improve their health IT infrastructure and some capital to invest in facility improvements through ARRA.”
The study breaks down the most recent funding:
- $2 billion has been directed by ARRA in a one-time appropriation to CHCs.
- $300 million has been extended to the National Health Services Corps, a CHC partner responsible for recruiting and placing healthcare professionals in “health professional shortage areas.”
- $47.6 million has been dedicated to primary care training programs for residents, medical students, physician assistants and dentists.
- $12.5 billion has been appropriated through recent healthcare reform legislation for the expansion of the CHCs and the NHSC over five years, beginning in 2011.
Health reform also established a new Title III grant program ($230 million over five years) for community-based teaching programs and authorized a new Title VII grant program for the development of primary care residency training programs in CHCs.
“CHCs are well-positioned, especially with the increased funding flowing to them, to expand their roles as safety net providers and to hopefully help serve newly insured people,” said Barr, formerly the chief medical officer of Baltimore Medical System, a federally qualified community health center.