Jeff HeltonHave you hugged your community health center today? Okay, so that is an odd question, but considering that some might think hospitals and local community health providers to be strange bedfellows, the question makes sense to me. If you happen to be a stranger to your local community health center, perhaps the New Year is a good time to make a new friend for your organization. 

Local community health providers come in a variety of forms, from federally qualified health centers (FQHCs) to the local community health centers that live on private donations to serve the poor and indigent. They also tend to serve a high proportion of Medicaid beneficiaries. We can probably all agree that the problem of care to the poor and indigent will not go away with the implementation of the Affordable Care Act this year. 

The slow adoption of health insurance products offered through state and federal insurance exchanges give ample support to that conclusion. The current higher age/gender risk profile of exchange participants for commercial insurance products suggests that affordability of those products may further inhibit growth of numbers in the insurance exchange population. Expansions of Medicaid enrollments (over 80,000 alone here in Colorado) suggest that there will be even more persons covered with reimbursement rates that average below operating costs. Put those two things together and it sure looks like hospitals need some help. Community health providers can be valuable allies in this new era.

Community health centers also are struggling with managing poor-to-nonexistent reimbursements, although they tend to be successful in establishing relationships with their patients and in promoting preventive health initiatives. Aren’t those the things we need help with to prevent unnecessary use of emergency services and avoidable readmissions? I’d say “yes.” 

So what can we do? There are as many answers out there as there are hospitals. Some good approaches to partnering with community health centers that I have seen work include setting up care coordination protocols, offering discounted reference lab services, providing coordination of Medicaid eligibility programs, and most important, instituting mutual data sharing (remember my comments last month about health information exchange?). All of us are fighting to deliver excellent care for patients while managing scare resources. Why not look at the providers in this unique niche of our healthcare system as potential partners to address a couple of our most distinct (and vexing) challenges? 

Jeffrey Helton, PhD, FHFMA, CMA, CFE, is assistant professor, Metropolitan State University of Denver.


Publication Date: Wednesday, January 22, 2014