MPCA News

How does the Accountable Care Act (Healthcare Reform Law) impact Community Health Centers?

1. The bill contains $11 Billion for the Community Health Center Program. The program as it exists now is funded at about $2.2 Billion. Health Centers currently serve 20 million patients. By doubling the funding, the expectation is that CHCs serve double the number of the current patients in five years.  The intent is for Community Health Centers to expand (primary care medical, oral, and behavioral health services) and new health centers to ramp up over the next 5 years to help provide access to primary care for the 32 million people, previously uninsured, who will be seeking care when the new insurance reforms start in 2014. Of the $11B, $9.5B will be put toward operations and $1.5B will be offered for capital improvements.
   
   HRSA will be developing New Start, Satellite, and expansion grant guidance for release this summer or fall, but they will probably not be able to give out grant dollars until the Spring of 2011.
   
   
2. The bill contains $1.5 Billion for the National Health Service Corps for the next five years which will place an estimated 15,000 primary care providers into shortage areas.
   
   
3. The bill expands Medicaid to 133% of the Federal Poverty Level in FY2014, without any categorical restrictions (such as must be blind or disabled), newly insuring 16 million Americans.
   
   
4. The bill requires that health centers receive no less than their Medicaid Prospective Payment System (PPS) per visit rate from private insurers offering plans through the new health insurance exchanges.
   
   
5. The bill requires that private health insurers to contract with Community Health Centers or Federally Qualified Health Centers (FQHCs) and FQHC Look Alikes.
   
   
6. The bill adds preventive services (mammograms, etc.) to the FQHC Medicare payment rate and eliminates the Medicare payment cap on FQHC payments.
   
   
7. The bill authorizes and funds new programs for health center-based residency programs.

And How Do Health Centers Keep Health Care Costs Down?

The Community Health Center provisions in the Health Reform bill reflect an investment in the quality and cost-effectiveness of the CHC program. The value that health centers offer includes decreased ER visits, hospital admissions and specialist care. Health center patient costs are 23% lower than care received elsewhere. With the implementation of these provisions, cost savings are projected to be $212 billion for the 2010-2019 time period (not including the savings for the current patients being served). For more information on the impact on health care costs through Community Health Centers, read the Geiger-Gibson/RCHN Community Health Research Collaborative “Using Primary Care to Bend the Curve: Estimating the Impact of a Health Center Expansion on Health Care Costs,” September 1, 2009.