Investments in community health centers that provide care for about 15 million people who are poor, underserved and uninsured have helped expand the services, according to new research. The funds sometimes also give technology a boost.
The authors of the new study, published in the February 2010 edition of the journal Health Affairs estimate that a $500,000 increase in grant support for all centers would provide treatment for an additional 500,000 uninsured patients. The study does not mention the use of healthcare information technology in expanding services. But several community centers have either built their own in-house electronic health record or installed one that is commercially available.
Two of the 2009 Davies Award winners given by the Healthcare Information and Management Systems Society – Urban Health Plan and Heart of Texas – are community health centers that have employed EHRs to improve care delivery.
Urban Health Plan operates 13 sites in the South Bronx and Queens boroughs in New York. It rolled out its health record in 2006, and CEO Paloma Hernandez says the EHR has helped transform healthcare delivery and helped eliminate healthcare disparities in the communities the centers serve.
Since it rolled out its EHR in 1997, Heart of Texas has expanded from a single location to 10 sites.
“The EHR has been a cornerstone of our expansion and quality improvement efforts,” said Roland A. Goertz, MD, CEO of Heart of Texas.
The authors of the new study say that their findings bode well for effective use of the more than $2 billion in funds provided to community health centers under the American Recovery and Reinvestment Act (ARRA).
The stimulus funding was the largest one-time investment in the centers in their history - and this study shows that in previous years, the centers used such investments to increase the care provided to low-income or underserved patients.
"Community health centers play a vital role in providing primary care and other services to those who cannot afford it or cannot access care," says lead author Anthony Lo Sasso, a researcher at the University of Illinois at Chicago School of Public Health. "They are an investment that pays off for patients and the nation as a whole."
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Researchers examined investments and their effects on care in 1996-2006 from federal, state and local or private sources in so-called federally qualified community health centers. These are "safety net" providers such as community health centers, public housing centers, outpatient health programs funded by the Indian Health Service, and programs serving migrants and the homeless that meet federal criteria for receiving funding. Federal grants to federally qualified community health centers, for example, have grown from roughly $550 million in 1990 to nearly $2 billion in 2007.
The study authors found that these and other public dollars helped increase all services, especially mental health and substance abuse treatment and counseling.
The authors predict that an additional $500,000 in federal grants to federally qualified health clinics would help provide $135,000 worth of free or discounted care and could translate into 540 more uninsured patients who receive treatment. If federally qualified health centers leveraged their federal grant support to gain additional state, local, and private grant dollars, this could lead to higher levels of service and more care for the uninsured, the researchers conclude.
The health policy journal Health Affairs is published by Project HOPE.
