Investments in Community Health Centers May Improve the Economy Along with Health

Think Tank Thursday. On August 9, I attended a panel discussion at the progressive think tank, Center for American Progress.  This panel convened by the Progress 2050 initiative discussed community health centers (CHCs) to launch the release of the new report The Importance of Community Health Centers:  Engines of Economic Activity and Job Creation by Ellen-Marie Whelan, NP, PhD, Associate Director of Health Policy at the Center.  Dr. Whelan was joined by Daniel Hawkins, Jr. of the National Association of Community Health Centers, Rebecca Keen-Fan Sze of the Wang Community Health Center and Stephanie Kenyon of the Loudoun Community Health Center for what I  consider to be an enlightening discussion of the role of community health centers in the current American healthcare system and its changing role during the current age of health care reform.

Created in 1965, community health centers were created to fill an existing gap in the healthcare system and meet specific criteria.  They must be located within and/or serve medically underserved areas and populations.  They must provide care to everyone regardless of their ability to pay.  CHCs must provide comprehensive health care services including primary care, dentistry, and specialty care (such as cardiology, orthopedics, podiatry, and psychiatric services).  In addition, they provide supportive services in an effort to reduce barriers to health care or compliance with medical regimens.  As a result, nutrition education,weight-reduction, case management, translation and transportation services are commonly made available to patients.  Finally, CHCs must be governed by a community board comprised of no less than 51% patients from the community.

Dr. Whelan reports, “The patients of these centers are also more likely to identify a usual source of care, and report having better relationships with their health care providers. This focus on primary care and the provision of additional supportive services are among the reasons that care delivered by community health centers is less expensive and ultimately saves money to the broader health care system. Studies estimate that the provision of care in community health centers ultimately saves the U.S. health care system between $9.9 billion and $24 billion annually by eliminating unnecessary emergency room visits and other hospital-based care.”

Although community health centers were created 45 years ago, similar gaps remain in today’s healthcare system.  This has made it necessary for both the previous Bush and the current Obama administrations to support the expansion of community health centers to fill these unmet needs.  With last year’s American Recovery and Reinvestment Act, the President allocated $2 billion for the expansion of operating budgets for existing community health centers and new construction.  With this funding, CHCs have served an additional 2.1 million patients in just one year.  Congressional budget experts and economist had projected the funding could support an expansion to serve 2.9 million additional patients over the course two years.  More importantly, with this report Dr. Whelan illustrates that reinvestment in community health centers has indeed yielded economic recovery (see Table 1).

She states, “…the $1.8 billion investment that the American Reinvestment and Recovery Act made in these centers in 2009 yielded $3.2 billion in total economic activity in those areas of the nation that needed it most. New jobs [measured in FTE] and in some cases brand new businesses that did not previously exist were created.”

The Patient Protection and Affordable Care Act, passed into law earlier this year commits $11 billion to community health centers over the next five years to expand services.  This funding will allow CHCs to expand their capacity through both operating and capital budgets.  With larger facilities, new services, additional health care professionals and support staff, community health centers can reconfigure to meet the needs of some 32 million Americans newly insured under this health law.  The panelists each identified budgetary priorities for their centers.  Sze states the Wang Community Health Center must expand its evening and weekend hours to meet the needs of its community. Kenyon has already identified new space for the Loudoun County Community Health Center to double their capacity and reduce its patient waiting list.  Daniel Hawkins concludes that health centers were “founded to be not only agents of care, but also agents of change,” and have “had an impact on the rest of the system.”   The analysis of Dr. Whelan’s report leaves me extremely optimistic about community health centers ability to make their contribution to improving our health care system.

Source: Whelan, E.  The Importance of Community Health Centers:  Engines of Economic Activity and Job Creation.  Issues: Domestic: Healthcare. Center for American Progress.  Accessed online August 19, 2010.

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