Community Health Centers play a critical role in the delivery of high quality, comprehensive primary care to nearly 2.4 million medically underserved Medicare beneficiaries. Medicare patients currently make up 9 percent of all health center patients nationally, and many health centers serve far more, especially those located in rural areas. In fact, Medicare patients make up at least 15 percent of total patients at roughly one out of every five health centers.
The number of Medicare beneficiaries served by health centers has doubled since 2005 and the numbers will continue to grow as health centers expand into new communities and as current patients age into eligibility for the insurance program. Two in five adult Medicare health center patients classify as Medicare-Medicaid dual eligible, who have extensive health care needs—double the national rate. They are significantly more likely to suffer from multiple chronic conditions such as diabetes and chronic lung disease. Health centers play a key role in assisting these seniors and their families in managing chronic diseases and maintaining healthy lifestyles.
Increasing the number and proportion of Medicare beneficiaries seeking care at health centers represents an opportunity to reduce overall Medicare costs. A review of Medicare claims data from 4.4 million beneficiaries in fourteen states found the total annual cost of care for health center patients was 10-30 percent lower than Medicare beneficiaries receiving their care elsewhere. Moreover, regions with the highest penetration of low-income residents served by health centers had 10 percent lower Medicare spending per beneficiary costs in other areas, including post-acute care, hospice, durable medical equipment, and Medicare Part B drugs.
NACHC Fact Sheets and One-Pagers
- America’s Health Centers, November 2017
- Health Centers and Medicare: Caring for America’s Seniors, May 2016
NACHC Comments and Responses
- CMS Releases Rule That Improves Care for Health Center Medicare Patients, November 2017
- NACHC Comments to Senate Finance Committee’s Request on Chronic Care Reform in Medicare, June 2015
- Overview of the Medicare FQHC PPS Final Rule
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