Social and Behavioral Sciences Commons^™

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, …

Designation Of Medically Underserved And Health Professional Shortage Areas: Analysis Of The Public Comments On The Withdrawn Proposed Regulation, Emily Jones, Leighton C. Ku, Joseph Lippi, Ramona Whittington, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In February 2008, the Health Resources and Services Administration (HRSA) proposed new regulations that would have modified and combined the Health Professional Shortage Area (HPSA) and Medically Underserved Area/Population (MUA/P) designation processes. The comment period was extended twice in response to the large volume of comments, through June 30th. On July 23rd, HRSA effectively withdrew the proposed rule, announcing that in light of its preliminary review of comments, the agency had elected to develop a new proposal. This Research Brief highlights some of the salient issues surrounding the proposed rule, based on an analysis of the public comments by researchers …

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. …

Access Transformed: Building A Primary Care Workforce For The 21st Century, Sara J. Rosenbaum, Peter Shin

Health Policy and Management Faculty Publications

Though access to primary care protects health and cuts costs, this report shows there aren't enough primary care doctors and nurses at health centers to meet the need, with some areas having almost none – a situation that cannot be solved just by expanding health insurance coverage. The report indicates the availability of a primary care workforce depends on where you live, and primary care clinicians are not locating in areas that need them most, especially low-income communities. The study includes state-level projections of growing patient needs expected to stretch the health care system in years ahead. It was conducted …

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 …

Health Centers: An Overview And Analysis Of Their Experiences With Private Health Insurance, Peter Shin, Brad Finnegan, Jessica Sharac, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

Steady growth in the number of uninsured and under-insured has sparked health reform proposals at the national and state levels. With many proposals emphasizing expanded access to private health insurance among the low-income population through the use of tax credits and an emphasis on stable and continuous primary care as a key to improving health care access, the interaction between health centers and private health insurance becomes an important aspect of national health policy. This policy brief provides an overview of health centers, with a special focus on the relationship between health centers and private health insurance.