A new report documents the increasingly visible role that community health centers are playing in the maturing, post-Affordable Care Act (ACA) health care market. Issued by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health, the report was published in partnership with the Kaiser Family Foundation.
“Community health centers provide comprehensive primary care services in some of the most underserved communities in the nation,” says Anne Markus, PhD, MHS, JD. The report, includes an examination of health centers’ outreach and enrollment activities and documents health center performance on multiple key measures based on a national survey conducted in early 2018.
The report analyzes growth in health center services and capacity in the past calendar year, with many centers reporting increases for mental health services and staff, substance use disorder treatment services and staff, chronic care management services, and dental services and staff. Even as the percentage of insured patients has continued to grow, more than half of surveyed health centers reported an increase in the past calendar year in insured patients unable to afford cost-sharing and deductibles.
Other topics discussed in the report include community health centers’ efforts to adjust to the shorter open enrollment period in effect in most states and the extensive enrollment assistance they continue to furnish, even as one-third of navigator funding recipients reported experiencing reduced navigator funding for 2017-2018.
“Looking ahead, health centers will remain critical sources of comprehensive primary care services as well as outreach and enrollment assistance in their communities,” Markus says. She and her coauthors stress that uncertainty over future funding remains, and delays in securing it could disrupt health center operations. They also note that 1115 Medicaid waiver proposals in several states to impose work requirements, premiums and cost-sharing and time limits on benefits “will restrict Medicaid enrollment, which could lead to coverage losses among health center patients, and further add to the financial uncertainty facing community health centers. For example, a recent publication by the Kaiser Family Foundation documents that over 4,300 Medicaid enrollees in Arkansas lost Medicaid coverage due to not meeting work requirements.
Community Health Centers' Experiences in a More Mature ACA Market was written by Markus, Jessica Sharac and Sara Rosenbaum of the Milken Institute School of Public Health’s Department of Health Policy and Management. Jennifer Tolbert and Julia Zur of the Kaiser Family Foundation are also authors of the report.