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Community Health Centers: A 2013 Profile and Prospects as ACA Implementation Proceeds

Community health centers are an integral part of the health care safety-net, providing access to care for nearly 22 million people in underserved communities. The ACA established trust fund for health center growth, and with increased patient revenues attributable to expanded coverage, health centers’ grant funding to support care of the uninsured can go further. This brief provides a 2013 data profile of health centers; highlights pre-ACA differences between health centers in Medicaid expansion and non-expansion states; and considers financial challenges facing health centers and the implications of state Medicaid decisions, the outcome of King v. Burwell, and the approaching sunset of the special trust fund for health centers’ capacity to ensure access to care for the communities they serve.

Federal and State Standards for “Essential Community Providers” under the ACA and Implications for Women’s Health

Safety net providers such as community health centers and family planning clinics have served a significant role in the provision of primary care and reproductive health care services to low-income and uninsured people, particularly women. The Affordable Care Act (ACA) has a provision aimed at assuring that newly-insured individuals, as well as those without coverage, can continue seeing their trusted safety net providers, also called Essential Community Providers (ECPs). This brief reviews the definition of ECPs, examines the federal and state rules that govern the extent to which plans must include these providers in their networks, identifies the variation from state to state, and discusses the particular importance of these rules and providers for women’s access to care.

Community Health Centers: A 2012 Profile and Spotlight on Implications of State Medicaid Expansion Decisions

Community health centers are an integral part of the health care safety-net, providing access to care for over 21 million people in the U.S. The ACA made a major investment in the health center program, and expanded health coverage will provide new revenues to health centers, permitting grant funding to support care of the uninsured to go further. This annual update provides a pre-ACA snapshot of community health centers and also examines newly reported data on “look-alike” health centers. In addition, the brief highlights significant differences between the profiles and revenue situations of health centers in Medicaid expansion and non-expansion states in 2012, before the ACA coverage expansions took effect. Finally, it considers financial challenges facing health centers and the implications of state Medicaid decisions for health centers and their capacity to ensure access to care for low-income communities they serve.

Integrating Physical and Behavioral Health Care: Promising Medicaid Models

Although many people require treatment for both physical and behavioral health conditions, our physical and behavioral health systems typically operate independently, without coordination. Medicaid has a significant stake in addressing this issue because physical and behavioral health comorbidity rates among beneficiaries are high. This brief examines five promising approaches currently underway in Medicaid to better integrate physical and behavioral health care.

A Profile of Community Health Center Patients: Implications for Policy

Community health centers are a key source of primary care in underserved areas. Their role will grow as coverage expands under the ACA. To sharpen understanding of the health center patient population, this brief compares them to the low-income population overall, using the Health Center Patient Survey and National Health Interview Survey. The pre-ACA profile of health center patients that emerges sets the stage for measuring change and highlights important implications of states’ Medicaid expansion decisions.

Providing Outreach and Enrollment Assistance: Lessons Learned from Community Health Centers in Massachusetts

As states and communities gear up to provide outreach and enrollment assistance under the ACA, the enrollment assistance experience of health centers in Massachusetts, where a major expansion of health coverage was implemented six years ago, offers valuable lessons that can help to inform current and emerging efforts by health centers and other community-based organizations to reach and enroll millions of low-income, uninsured Americans in health insurance.

Quality of Care in Community Health Centers and Factors Associated with Performance

This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.

Community Health Centers: Can They Plug the Gaps in the Safety Net?

The Alliance for Health Reform and the Centene Corporation sponsored a July 23 briefing to discuss the role of community health centers (CHCs) in providing care to vulnerable populations as employer-sponsored coverage declines and demand for safety-net services increase. Panelists addressed questions such as: How are states and safety-net systems…