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NACHC, Citing Cost Benefits, Urges Alliances with Hospitals

By Alexandra Wilson Pecci, for HealthLeaders Media  
   March 23, 2011

If healthcare has a Holy Grail, it's this: Finding solutions that both lower costs and improve quality. According to a new policy brief released Tuesday, community health centers are poised to take one step closer to achieving that goal.

The National Association of Community Health Centers' policy brief, "Community Health Centers: The Local Prescription for Better Quality and Lower Costs," was unveiled at a Capitol Hill briefing. The brief not only calls for establishing more community health centers throughout the country, it also calls for stronger alliances between community health centers and hospitals. Here's the convincer: The brief cites dozens of studies showing the cost savings—$24 billion per year—and improved care that such centers can provide.

Community health centers provide primary care to patients who might not otherwise have access to it, especially the uninsured. They not only help these patients stay healthy, but also help them avoid trips to the hospital, Michelle Proser, director of research at the NACHC, said in an interview.

"Health centers are primary care providers, and many patients that would not have access to primary care may end up in the emergency room for services that could have been provided in a primary care setting," she said.

This is true not only in urban areas, but also in rural ones, where Proser says half of community health centers are located. For example, the policy brief cites a 2009 study published in the Journal of Rural Health that found 33% higher rates of uninsured all-cause ED visits in rural Georgia counties without a community health center, than in counties with community health centers.

But it's not just about preventing trips to the ED, Proser says.

"I think there's a lot to be said in creating local partnerships to make sure that patients have the full gamut of care," she explained. "There's a time and place for all sorts of services, and a patient needs adequate access to primary care as well as specialty care services, inpatient care services, and so on."

Proser says community health centers are "on the ground" in ways that other healthcare providers sometimes aren't, providing care that's tailored to a population and its specific needs. And increasingly, this leads to partnerships between local hospitals and community health centers to create a system of care for that community.

"I think hospitals can look at this and see that health centers are very effective and very high-quality primary care providers," Proser said. For example, according to the policy brief, community health center patients received more pap smears and mental health services and seniors received more vaccinations than patients of other providers.

Moreover, data from the Agency for Healthcare Research and Quality shows that health centers' cost per patient is dramatically lower than other healthcare settings. According to the policy brief, these cost savings and health improvements come not only from community health centers' ability to coordinate and provide care, but also to empower and educate patients about how and when to seek medical care in the first place.

"Hopefully this will help hospitals see that there are community health centers in their communities that perhaps they should be partnering with if they haven't already done so," Proser says.

If there were ever a time for hospitals to partner with their local community health centers, it's now. According to the NACHC brief, health centers currently operate in more than 8,000 locations and serve 23 million patients, providing one-quarter of all primary care visits for the country's low-income population. And with continued government investment, they're on track to double the number of patients and triple the savings through 2015, according to the brief.

That's not to say that community health centers don't have their own challenges. A 2010  New England Journal of Medicine Perspective cites increasing numbers of uninsured patients, a lack of health IT, and "reimbursement policies that undervalue primary care services." But as more resources—and bipartisan support—are continually funneled into expanding community health centers, their influence is hard to ignore.

"In creating a system of care, at the heart of that system, or at the foundation, there needs to be a high-quality primary care model, and health centers offer that…especially for patients that are more at risk for poor outcomes," Proser says.

Read the full policy brief here.

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