Community Health Centers And Medicaid At 50: An Enduring Relationship Essential For Health System Transformation

Abstract

Community health centers reach their fiftieth anniversary in 2015, along with Medicaid. Health policy makers have understood the programs' symbiotic connection from the earliest days of their implementation. Medicaid's expansion and growth have made the modern community health center program possible, while health centers represent one of the principal sources of primary care for the nation's Medicaid population. With their shared mission and high level of interdependence, Medicaid and community health centers are essential for continued health system transformation in medically underserved communities nationwide--for example, by implementing delivery system reforms aimed at increasing clinical integration and improving efficiencies and by becoming medical homes for high-risk patients. Achieving this transformation will depend on the ability of community health centers and Medicaid to understand and respond to the challenges that each faces, while fully deploying the strengths that each has to offer.

Health Care Utilization Rates After Oregon’s 2008 Medicaid Expansion

“…(27, 28) We also discovered that over 20% of enrollees who sought outpatient care used safety net clinics, and this proportion increased over time in all groups. This finding is consistent with the national trend of increased utilization of safety net clinics among Medicaid-insured patients(29) and confirms prior findings that patients do not leave safety net settings once they gain insurance coverage; instead, demand for safety net services increases. (3, 11, 15)…”

Aging in Puerto Rico: A Comparison of Health Status Among Island Puerto Rican and Mainland U.S. Older Adults

“…The 1993 Puerto Rican Health Care Reform increased access to medical, dental, and hospital care for poor and under-served populations, including the elderly (Santos-Lozada, 2013). The uninsured rate in Puerto Rico declined steadily since the mid-1990s (Schin, Sharac, Luis, & Rosenbaum, 2015). This expansion of health insurance likely resulted in more Puerto Ricans having a usual source of care and access to preventive health care services.…”

“…It is important to note that unlike the other health indicators examined in this study, diabetes and hypertension can be controlled with medications, and thus reports of prior diagnosis of these conditions may have a different meaning for current health status. Analysis of health center outcomes data from the Health Resources and Services Administration suggests higher rates of control in Puerto Rico compared with the rest of the United States; 75% of hypertensive patients had controlled blood pressure in Puerto Rico compared with 63% of other U.S. patients, and 73% of diabetics had HbA1c levels in the “normal” range compared with 68% of other U.S. diabetic patients (Schin et al, 2015). Nonetheless, it is troubling that island Puerto Ricans have much higher rates of hypertension and diabetes compared with their U.S. non-Hispanic White counterparts and higher hypertension than mainland-born U.S. Hispanics.…”

The Importance of Partnerships in Local Health Department Practice Among Communities With Exceptional Maternal and Child Health Outcomes

“…[39][40][41] Research by Harris and Mueller 42 indicates that urban jurisdictions carry out significantly more policy and advocacy activities, planning and policy development activities, and policy and advocacy communication activities than their counterparts in smaller jurisdictions. The LHD leaders in our sample adapted to state and local policy changes that impacted their ability to receive reimbursements for clinical services by changing their own policies regardless of community type.…”