Community health centers that are closely affiliated with hospitals have fewer difficulties setting up appointments for specialty procedures like x-rays, diagnostic tests and visits with physicians, according to a Commonwealth Fund survey.
The survey indicated centers without hospital affiliations have a difficult time getting off-site specialty appointments regardless of a patient's insurance status.
"Enhancing the Capacity of Community Health Centers to Achieve High Performance" includes results from nearly 800 federally qualified health centers across the country. It examines the centers' capacity to provide high quality healthcare and function as patient-centered medical homes.
"Community health centers are a vital component of our healthcare system and this survey gives us a comprehensive picture of their current capacity to provide patient-centered, high-quality care," said Commonwealth Fund President Karen Davis. "Moving forward, we should continue to invest in strategies that will strengthen community health centers' ability to provide comprehensive care to patients and reduce barriers to obtaining needed specialty care."
The survey spotlights areas where improvements can be made, including payment incentives to encourage high quality care; policies and incentives that encourage centers to take the necessary steps to function as patient-centered medical homes; and infrastructure support like health IT that will allow health centers to better meet patients' needs.
CHCs serve an estimated 16 million patients who are predominantly low-income, uninsured or insured through Medicare or Medicaid. According to the report, many CHCs already provide high quality, well-coordinated care, but the passage of the Patient Protection and Affordable Care Act could increase demand for their services nationwide.
Other findings include:
- 71 percent of CHCs can usually provide patients with same/next day appointments, or can usually provide patients with telephone advice on clinical issues during office hours or on weekends or after-hours;
- Seven in 10 centers have office systems which allow them to easily generate lists of patients by diagnosis (69 percent) or easily track referrals until the consultation report returns to the referring provider (70 percent).
- 45 percent of centers with all the attributes of a medical home are notified if a patient goes to the emergency room, compared with only 20 percent of centers with only a few medical home attributes.
- 40 percent of health centers use electronic medical records, which is nearly the same rate as practitioners in other settings, where 46 percent use electronic medical records.
The survey also found that health centers with medical home capabilities were more likely to report they have an adequate workforce and not face shortages of physicians: 43 percent of centers with all the characteristics of a medical home have an adequate physician workforce, compared to only 24 percent of centers that only have a few of the characteristics.