Comparison of Nurse Managed Health Centers With Federally Qualified Health Centers as Safety Net Providers

Abstract

Nurse Managed Health Centers (NMHCs) provide a critical safety net function in their communities, yet they often remain invisible and challenged in terms of financial sustainability. This paper presents a comparison of demographics and financial status of NMHCs and Federally Qualified Health Centers (FQHCs). The comparison is based on four years of annual NMHC national survey data that includes 42 NMHCs overall and the 2008 FQHC data in the Uniform Data System. Findings indicate that NMHCs and FQHCs serve very similar diverse populations yet funding and revenue differences were significant. NMHCs tend to rely more on grants and donations from the private sector as well as contracts while FQHCs have access to considerable federal support that is cost based when serving the underserved. In addition, NMHCs are challenged by the array of state, federal and third party insurers' regulations that often disadvantage nurse practitioners as primary care providers.

Lessons Learned From Examining After-Hours Call Patterns

“…15,16 NMHCs had their origins in community-based care and date back to visionaries such as Lilian Wald in the early part of the 20th century. 17 Schools of nursing have developed NMHCs over the years to provide opportunities for faculty practice, faculty and student research, clinical placement for students, and fulfillment of a community service mission.…”

“…Typically NMHCs are affiliated with academic settings and provide rich clinical settings for students and faculty. 16,22 In the 2 NMHCs involved in this study, the same staff and providers (primarily NPs) practiced at both NMHCs and were also responsible for afterhours calls. They were likely to either know patients who called or be able to access the other providers and the electronic health record as needed to obtain patient information.…”

“…17 Schools of nursing have developed NMHCs over the years to provide opportunities for faculty practice, faculty and student research, clinical placement for students, and fulfillment of a community service mission. 15,16 The number of NMHCs is unknown as there is no national tracking of centers, but estimates range between 200 and 300. In a national sample of schools of nursing in 2006, there were close to 200 NMHCs, and that number did not include the numerous other NMHCs not linked with academia.…”

NP-led obesity clinics: a NP guided primary care approach for managing obesity in low income preschool-age children in Canada

“…Since the launch of this initiative, NMHCs in Philadelphia have thrived. Accordingly, Philadelphia has been recognized as a leader in the implementation ofNMHCs and is the foundation for which the integration of future NMHCs is based on (Bailey et al , 2009) NMHCs (Esperat et al , 2012;Pohl et al , 2011). Additionally, NMHCs can now meet the criteria for consideration by accrediting bodies for formal designation as a patient-centered medical home and thus be considered for grants and contracts from the Centers for Medicare and Medicaid Services (Esperat et al, 2012).…”

“…According to Barkauskas et al (2011), NMHCs are most often sponsored by schools of nursing. In fact approximately 20%-27% of non-operating revenue is obtained by subsidies from universities and schools of nursing (Pohl, Tanner, Pilon, & Benkert, 2011). Nonfederal sources for NMHCs are the National Nursing Centers Consortium (NNCC) and the Institute for Nursing Centers (INC).…”