America’s Health Centers: Realizing the Promise of National Health Reform

by Craig A. Kennedy, MPH, Associate Vice-President, Federal & State Affairs, National Association of Community Health Centers (as published in the Michigan Primary Care Association newsletter, News & Notes, Spring 2010)

Health Center 45 year anniversary logoHealth Centers deliver cost-effective care to vulnerable populations every day, bending the cost-curve to generate $24 billion in health system savings each year.    

Now that health reform has been signed into law by President Obama, the next few years will see large scale changes to our heath care system.  After decades of talking about it, planning for it, and even making some headway with new programs (CHIP, Medicare drug plan, etc.), we now begin the long and complex process of implementing a comprehensive reform package.  While there will be some new structures created, we aren’t starting completely from scratch – the bill will greatly expand the Health Centers program in the years ahead.  

As we have been saying for years, “Health Centers Work”, and this reform bill recognizes that record of success.  Health Centers’ 20 million patients nationwide receive comprehensive, high-quality primary care.  At Health Centers, access and quality come with overall savings, rather than a cost – and that is why the reform package includes a doubling of the program from its current service levels.  Health Centers deliver cost-effective care to vulnerable populations every day, bending the cost-curve to generate $24 billion in health system savings each year.  Health Centers may not be the only providers of care in the country, but they are certainly the very best at providing access to low-cost preventive and primary care services.  

And this is exactly what Congress sought to expand in the health reform bill.  Health Center supporters in both chambers embraced the model, expanding the program to build a foundation for nationwide health care delivery reform.  With great help from our champions, especially Senator Bernie Sanders (I-VT), the Health Centers program and the National Health Service Corps (NHSC) now have a dedicated trust fund with $12.5 billion in new funding over the next five years.  Health Centers will receive $9.5 billion to expand their operational capacity to serve nearly 20 million new patients and to enhance their medical, oral and behavioral services; another $1.5 billion will allow Health Centers to begin to meet their extraordinary capital needs; and the remaining $1.5 billion will go to the NHSC to place roughly 15,000 primary care providers in provider-short communities, many of whom will likely serve in Health Centers.  Finally, with strong support in the Senate Finance Committee from Senators Robert Menendez (D-NJ) and Debbie Stabenow (D-MI), starting in 2014 Health Centers will be paid no less than their Medicaid Prospective Payment System (PPS) rate by all private insurance plans offered in the new state-based insurance Exchanges.  Additionally, the law mandates that all of the private plans in the Exchange be required to contract with Health Centers.  These two provisions, along with the expansion of Medicaid to enroll more than 16 million new people, ensure that every Health Center will participate in the expansion of insurance, and also be reimbursed for the comprehensive care they provide.  These and many other provisions in health reform impacting Health Centers and Health Center patients are detailed at www.nachc.com/healthreform.cfm.  

For the past 45 years the Health Centers program has proven beyond a reasonable doubt that it is a success.  For the past decade we have shown that we can sustain growth, and the past year has shown that major investments (i.e. – the Stimulus) will be put to good use.  This bill now takes that one step further – and toward the development of a comprehensive primary care safety net for everyone in this country through a Health Center.  We have a long way to go, but this new law will allow Health Centers to reach more than 40 million people if we deliver on the faith Congress has now placed in us all.  Health Centers will grow faster than they have ever grown before, and it will take intensive planning, strategic thinking and partnerships, creative leveraging of resources and old-fashioned community outreach.  But it will be worth it.  Because in five years, ten years, twenty years, every Health Center patient, staff, board member and advocate will look back at this time and be able to say we were there when Health Centers became the foundation of the American health care infrastructure and the provider of choice in every community.

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