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DELIVERING QUALITYTHE HEALTH CENTER MODEL OF PRIMARY CARE
Health Centers provide high-quality, effective, and affordable primary care services that are typically as good or better (according to several different measures) that those available in other primary care settings. The fastest way to expand access to care is to lower costs while maintaining and improving quality. Health Centers have been national leaders in the transition to a high-quality, performance-based health care system. Several recent examples include:
- Leading the Way in Quality of Care. A recent study by the United Health Foundation found that Health Centers compare favorably with national measures of clinical quality and patient satisfaction, and that they showed a strong ability to raise performance levels consistently over time. The study concluded that, while Health Centers are driven by the mission to serve low-income and medically underserved populations, that in fact the Health Center model is a promising one for all primary care delivery.*
- Better Results, Lower Costs. Health Centers’ efforts have improved health outcomes and lowered the costs of treating patients with chronic illnesses. In a major study in South Carolina, Health Center Medicaid patients with diabetes cost $400 less per patient that diabetic Medicaid patients treated by other providers*. These savings were driven by lower emergency room and hospital visits, as well as lower costs for specialists, lab work, and other services. Health Centers generated savings despite having higher office visits per patient and more patients with multiple conditions.
- Saving Money Through Reduced Hospital Admissions. Patients in underserved areas served by Health Centers had 5.8 fewer preventable hospitalizations per 1,000 people over 3 years than those in areas not served by a Health Center. A recent NACHC analysis found that if avoidable visits to emergency rooms were redirected to Health Centers, over $18 billion in annual health care costs could be saved nationally*.
In order to reach more patients and more communities, Health Centers must continue to demonstrate high performance and improved health outcomes in their patients. Only with the kind of local input and constant innovation inherent to the Health Center model of care can the goal of access for all in need be realized.
A MULTI-PART PATHWAY FOR GROWTH
A reasonable long-term growth plan must have intermittent benchmarks and targets, both as policy goals and to measure progress towards a common vision. The first goal for Health Center growth would be expansion to serve 20 million patients by 2010.
The second multi-year benchmark for patient growth will be an expansion to reach nearly 15 million additional patients by the year 2015. By consistently escalating the rate of growth for 8 years, Health Centers can become health care home for nearly twice the patients currently served. By 2015, 30 million patients can have access to high-quality primary care in a Health Center. The foundation for this growth will be Health Center grant funding levels that recognize both increased costs and increased patient loads.
20 MILLION BY 2010, 30 MILLION BY 2015:
| Year | % Increase | CHC Appropriation | Total Patients |
| Fy2008 | NA | $2,065,000,000 | 17.4 million |
| FY2009 | 12.0% | $2,313,000,000 | 18.6 million |
| FY2010 | 12.5% | $2,602,000,000 | 19.9 million |
| FY2011 | 13.0% | $2,940,000,000 | 21.4 million |
| FY2012 | 13.5% | $3,337,000,000 | 23 million |
| FY2013 | 14.0% | $3,804,000,000 | 25 million |
| FY2014 | 14.5% | $4,356,000,000 | 27.2 million |
| FY2015 | 15.0% | $5,009,000,000 | 29.7 million |
By 2015, Health Centers will:
- Serve as the foundation for a high-quality, performance based health care system, grounded in primary care;
- Provide access to mental health, dental, and pharmacy services in every Health Center; and
- Implement networking and health information technology (HIT) in order to save costs and improve health outcomes.
Beyond 2015, growth in the Health Centers program must continue at a rapid pace in order to bring a health care home to all medically disenfranchised people in the United States. With continued growth at fifteen percent annually, Health Centers will serve 44 million patients by 2020, and all medically disenfranchised patients by 2026.
* Shin P, Markus A, and Rosenbaum S. Measuring Health Centers against Standard Indicators of High Quality Performance: Early Results from a Multi-Site Demonstration Project. Interim Report. Prepared for the United Health Foundation, August 2006.
* South Carolina Budget and Control Board, 2004.
* Source: NACHC, 2006 Access to Community Health Databook. Available online at
