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Community Health Centers: Can They Plug the Gaps in the Safety Net?

Monday, July 23, 2012

Community health centers (CHCs) play a critical role in providing care to vulnerable populations, especially at a time when employer-sponsored coverage has declined and the demand for safety-net services has gone up. Currently, there are more than 1,100 community health centers providing care to approximately 20.2 million people in every state across the U.S.

The centers have historically received bipartisan support: under the George W. Bush administration, the number of patients seen by CHCs doubled. And under President Obama, an additional $2 billion in the American Recovery and Reinvestment Act of 2009 was provided to CHCs to expand their operations and build new centers.

These centers are in a unique position to serve the millions more who will gain coverage under the Patient Protection and Affordable Care Act (ACA). Nearly forty percent of current CHC patients have no health insurance; approximately one third are children. Though questions remain as to which states will opt for the Medicaid expansion provisions in the law, there is little doubt that many more residents will be served by CHCs.

Researchers have shown that the quality of care in federally qualified community health centers compares favorably to primary care in other settings. In fact, according to a recent study, they perform equal to, or better than, private practices on a number of quality-care measures, despite the social and medical complexities of their patient populations.

Who do community health centers currently serve and how will this change as the health reform law plays out? How are CHCs faring in the current economic environment? Is there sufficient federal oversight of their operations? How are states and safety-net systems planning for 2014 and the challenges and opportunities presented under the ACA? What will be the impact of scheduled cuts to discretionary programs under the Budget Control Act of 2011 (the sequester)?

To address these questions and more, the Alliance for Health Reform and the Centene Corporation sponsored a July 23 briefing. Speakers were: Laurie Felland, Center for Studying Health System Change; Dan Hawkins, National Association of Community Health Centers; Henry Taylor, Miles Square Health Center, IL; Steven Shattls, Valley Health Systems, WV; and Dr. Elisa Nicholas, The Childrenís Clinic, Long Beach, CA. Helen Bryson of Centene and Ed Howard of the Alliance co-moderated.


 Dan Hawkins, Nat. Assn. of Community Health Centers, Speaker
 Laurie Felland, Center for Studying Health System Change, Speaker
 Henry Taylor, Miles Square Health Center, Chicago, Speaker
 Steven Shattls, Valley Health Systems, W.Va. , Speaker
 Elisa Nicholas, MD, The Children's Clinic, Long Beach, CA, Speaker
 Ed Howard, Alliance for Health Reform, Moderator
 Helen Bryson, Centene Corporation , Moderator
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Briefing Transcript (Adobe Acrobat PDF), 7/23/2012
Full Webcast/Podcast: Community Health Centers: Can They Plug the Gaps in the Safety Net?

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Dan Hawkins' Presentation (Adobe Acrobat PDF), 7/23/2012
Laurie Felland's Presentation (Adobe Acrobat PDF), 7/23/2012
Henry Taylor's Presentation (Adobe Acrobat PDF), 7/23/2012

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Materials List (Adobe Acrobat PDF), , 7/23/2012
Source List (Adobe Acrobat PDF), , 7/23/2012

Offsite Materials (briefing documents saved on other websites)

2011 Grant Award Process Highlighted Need and Special Populations and Merits Evaluation, Government Accountability Office, 5/1/2012
Study: Community Health Centers Sometimes Top Private Practices, Los Angeles Times, 7/11/2012
- Bardin, Jon
Community Health Centers: The Challenge of Growing to Meet the Need for Primary Care in Medically Underserved Communities (Adobe Acrobat PDF),Kaiser Commission on Medicaid and the Uninsured, 3/1/2012
Cost Effectiveness of Care Provided at Health Centers (Adobe Acrobat PDF),National Association of Community Health Centers, 11/1/2011
Improved Oversight Needed to Ensure Grantee Compliance with Requirements, Government Accountability Office, 5/1/2012
GAO Finds HRSA Failing Taxpayers, Patients, Due to Ineffective Management of Community Health Center Program, Offices of Senators Tom Coburn, Michael Enzi, and Richard Burr, 6/21/2012
How the Supreme Courtís Medicaid Decision May Affect Health Centers: An Early Estimate, Geiger Gibson /RCHN Community Health Foundation Research Collaborative, 7/19/2012
- Hayes, Katherine, Peter Shin, and Sara Rosenbaum
A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform, Center for Studying Health System Change., 11/1/2011
- Katz, Aaron, Laurie Felland, et al
United States health Center Fact Sheet (Adobe Acrobat PDF),National Association of Community Health Centers, 8/1/2011
Addressing Chronic Disease through Community Health Workers: A Policy and Systems Level Approach (Adobe Acrobat PDF),Centers for Disease Control and Prevention, 1/1/2012
Federally Qualified Health Centers and Private Practice Performances on Ambulatory Care Measures, Goldman, L. Elizabether, Phillip Chu, Huong Tran, and Randall Stafford, 7/10/2012
- Goldman, L. Elizabether, Phillip Chu, Huong Tran, and Randall Stafford
The Future Role of Community Health Centers in a Changing Health Care Landscape, The Journal of Ambulatory Care Management, 1/1/2011
- Hawkins, Dan and DaShawn Groves
Health Wanted: The State of Unmet Need for Primary Care in America., National Association of Community Health Centers, 3/1/2012
Transforming Community Health Centers Into Patient-Centered Medical Homes: The Role of Payment Reform., The Commonwealth Fund, 9/1/2011
- Ku, Leighton, Peter Shin, Emily Jones, et al
Emerging Issues in the FQHC Prospective Payment System, National Association of Community Health Centers, 9/1/2011
- Leifer, Jacqueline and Matthew Freedus
National Survey of Community Health Centers Finds Those Closely Affiliated with Hospitals Report Fewer Problems Obtaining Specialty Care for Patients, The Commonwealth Fund, 5/27/2010
New Access Point Grant Awards, Health Resources and Services Association, 6/20/2012
Association Between Patient-Centered Medical Home Rating and Operating Cost at Federally Funded Health Centers, Journal of American Medical Association, 6/24/2012
- Nocon, Robert, Ravi Sharma, Jonathan Birnberg, et a
Assessing and Addressing Legal Barriers to the Clinical Integration of Community Health Centers and Other Community Providers, The Commonwealth Fund, 7/1/2012
- Rosenbaum, Sara, Marcie H. Zakheim, Jacqueline C. Leifer et al
Medicaid Patients Seen At Federally Qualified Health Centers Use Hospital Services Less Than Those Seen By Private Providers, Health Affairs, 7/1/2012
- Rothkopf, Jennifer, Katie Brookler, Sandeep Wadhwa and Michael Sajovetz


Helen Bryson of the Centene Corporation set the stage for a discussion of community health centers' role in a reforming health care system. From the July 23 briefing cosponsored by Centene.

Laurie Felland of the Center for Studying Health System Change noted the growing importance of community health centers in serving Medicaid patients, at the July 23 briefing cosponsored by the Centene Corporation.

Dan Hawkins of the National Association of Community Health Centers described the vital role the centers play in the U.S. health care system, at the July 23 briefing cosponsored by the Centene Corporation.

Henry Taylor of the Mile Square Health Center in Chicago describes how "telehealth" is helping patients in underserved communities get the specialty care they need. From the July 23 briefing cosponsored by the Centene Corporation. (7 min.)


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