Public Health Commons^™

The Role Of Community Health Centers In Addressing The Needs Of Uninsured Low-Income Workers: Implications Of Proposed Federal Funding Reductions, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The severe economic downturn over the past few years has demonstrated the heightened importance of strengthening the health care safety net, particularly for working Americans who may have lost their health insurance coverage or do not have access to employer-sponsored benefits. Both historically and most recently during the current recession, health centers have played a critical role in providing services to the working poor, assuring that they continue to receive timely preventive care that obviates the need for, and minimizes use of, more costly services. We estimate that 1 in 4 low income, uninsured working adults depend on health centers …

Health Center Data Warehouses: Opportunities And Challenges For Quality Improvement, A. Seiji Hayashi, Emily Jones, David M. Stevens, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This Policy Research Brief reports on a pilot effort to leverage the growing presence of health center data warehouses to advance health care quality improvement through data sharing and exchange. This project builds on a partnership between the Michigan Primary Care Association and The George Washington University's Geiger Gibson/RCHN Community Health Foundation Research Collaborative that centers on developing approaches to using existing health center data for quality improvement.

Community Health Centers In Indiana: State Investments And Returns, Avi Dor, Patrick Richard, Ellen Tan, Sara J. Rosenbaum, Peter Shin, Lee Repasch

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Indiana Community Health Centers (I-CHC), including Federally Qualified Health Centers (FQHCs) and State Funded Health Centers (SFHCs), play a vital role in caring for the state's most vulnerable populations. Although their patient base tends to be poorer and experience greater health challenges than the general population, these health centers have generated substantial health care savings while providing high quality, low cost care. In this brief, key findings are presented from a recent study, conducted for the Indiana State Department of Health by GWU faculty and staff that was designed to estimate the cost savings and benefits generated by the state's …

Estimating The Effects Of Health Reform On Health Centers' Capacity To Expand To New Medically Underserved Communities And Populations, Leighton C. Ku, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Nearly 100 million persons reside in urban and rural communities that can be considered medically underserved as a result of inadequate supply of primary care physicians and elevated health risks. A report by the National Association of Community Health Centers and the Robert Graham Center estimated that 60 million people are "medically disenfranchised" and lack access to adequate primary health care because of where they live, even though many have health insurance. This brief assesses the potential effects of national health reform on health centers and on the number of patients they can serve. Because improving primary care access is …

Examining The Experiences Of Puerto Rico's Community Health Centers Under The Government Health Insurance Plan, A. Seiji Hayashi, Brad Finnegan, Peter Shin, Emily Jones, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief examines the experiences of Puerto Rico's community health centers under the Commonwealth’s 1994 Government Health Insurance Plan (GHIP) – the Commonwealth's Medicaid program – also known as the Reforma. Of particular interest are the effects of Medicaid under-financing coupled with health centers' continuing obligations to furnish subsidized care for uninsured patients. To finance GHIP, the Commonwealth substantially curtailed its involvement with the direct provision of health care in both community and inpatient settings, transforming the former system of direct care provision into health insurance premium subsidies.

In 2007, the 47 operating sites of Puerto Rico's 19 federally …

Assessing The Effects Of Medicaid Documentation Requirements On Health Centers And Their Patients: Results Of A "Second Wave" Survey, Lee Repasch, Brad Finnegan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This report represents a "second wave" follow-up to a "first wave" study whose purpose was to measure the effects of the Deficit Reduction Act's citizenship documentation requirements on health centers and their patients. The earlier study, conducted six months after implementation, found that the law had a widespread impact, including delayed applications, interrupted enrollment, disruptions in care, and at least anecdotal evidence of a growth in the number of uninsured patients as a result of the denial or loss of Medicaid coverage. This "second wave" survey underscores the existence of serious, ongoing problems more than a year after implementation. Specifically, …

Uninsured And Medicaid Patients' Access To Preventive Care: Comparison Of Health Centers And Other Primary Care Providers, Avi Dor, Yuriy Pylypchuck, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This issue of Research Briefs examines health centers' role in reducing disparities in preventive health care access by medically vulnerable and high risk populations. The analysis uses information from several national data sources to examine differences in the provision of preventive health care to Medicaid and uninsured patients between health centers and other primary care providers.

Key Findings:

• Compared to those treated by other primary care providers, Medicaid and uninsured patients treated by health centers are significantly poorer, in significantly worse health, and in the case of uninsured patients, more likely to be members of racial and ethnic minority groups. …

Grantee-Level Estimates Show That 31 Percent Of All Health Centers Would Fail To Meet Tier Two Status Under Hrsa's Proposed Mua/Mup/Hpsa Designation Regulations, Peter Shin, Leighton C. Ku, Emily Jones, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In April of 2008, we issued a research brief which analyzed the impact on various federal programs of a February 29, 2008 Notice of Proposed Rulemaking (NPRM) regarding the designation of Medically Underserved Populations and Health Professional Shortage Areas. Among its findings, the report estimated that resources for one-third of community health center sites would be jeopardized by this rule change because they could not attain a sufficiently high priority status, even under the newly-proposed, higher-scoring Tier 2 methodology. On May 1, 2008, we issued a revision in response to an April 21, 2008 clarification notice from the Health Resources …

Analysis Of The Proposed Rule On Designation Of Medically Underserved Populations And Health Professional Shortage Areas, Peter Shin, Leighton C. Ku, Emily Jones, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Numerous safety net programs and health care providers depend on Medically Underserved Area and Population (MUA/P) and Health Professional Shortage (HPSA) designations to qualify for federal funding, physician subsidies and placement, and health-related investments to improve access to care for communities and populations at high risk of poor health. These resources are particularly critical for federally-qualified health centers at a time when the number of uninsured is growing and the capacity of the safety net shrinking. On February 29, 2008, the Department of Health and Human Services (HHS) released a proposed regulation to alter the way these designations are made. …

Highlights: Analysis Of The Proposed Rule On Designation Of Medically Underserved Populations And Health Professional Shortage Areas, Peter Shin, Leighton C. Ku, Emily Jones, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

For decades, the federal government has targeted health care funding, resources and staff to meet the health care needs of areas designated as "medically underserved areas" and "health professional shortage areas." Areas that qualify may, for example, receive federal funding to support the establishment and operation of community health centers, or receive National Health Service Corps (NHSC) physicians and clinicians. In addition, physicians who practice in these health shortage areas may receive higher payments under Medicare. These designations thus affect the availability of health care in thousands of urban and rural areas all across the United States. Community health centers …

How Does Investment In Community Health Centers Affect The Economy?, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The economic slowdown that began in 2007 has prompted policymakers to focus on investments that can produce rapid economic gains in communities. Building on a previous analysis, this Research Brief estimates that a $250 million appropriations increase in the community health centers program would yield health care for an additional 1.8 million patients and a nationwide four-to-one return on investment:

• nearly $1 billion in direct community economic benefits, and
• over $1.1 billion in indirect benefits in jobs and other community investments.

On a state-by-state basis, each $1 million in federal appropriations would assure care for an additional 8,400 patients and …