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NACHC Response to Washington Post/Kaiser Health News Article Regarding Health Centers

NACHC Interim President and CEO Rachel Gonzales-Hanson sent the following letter to the editors of the Washington Post and Kaiser Health News.  To read shortened version of the letter  published by Kaiser Health News please visit this link.

An article by Phil Galewitz and Bram Sable-Smith  paints a grossly inaccurate picture of Community Health Centers across our nation and their mission of delivering life-sustaining quality care to more than 30 million Americans. The conclusions drawn in the piece are based on data representing fewer than one percent of health centers nationwide. Framing an argument on a cherry-picked handful of health centers
out of nearly 1,400 nationwide may generate a compelling headline, but also skews the facts. The broader, more accurate picture tells quite a different story.

In recent years, health centers fought on the front lines of a devastating pandemic and saved lives. Fewer people were infected with COVID-19 or died from the virus when a health center was nearby – and such efforts came at a cost: most health centers are operating on thin
margins and struggling to recruit and retain staff even while battling public health crises on multiple fronts. The bottom line is that health centers are expected to be successful fiscal models to ensure  they remain sustainable and can continue to deliver care amid financial challenges and uncertainty. Financial resilience for health centers is essential because federal support has never been as certain as the challenges associated with caring for people in low-income communities.

Health centers’ financial reserves are not secreted away, but rather are regularly reported, publicly available for scrutiny and subjected to annual fiscal audits. In some cases, if allowable, these extra dollars go toward new site expansions, increased staffing, or expanded services to
address identified unmet needs in an underserved community. One lesson that health centers learned from the COVID-19 pandemic is that they are the “canaries in the coal mine” of public health and require immediate access to funding to adapt care in nimble and innovative ways. Health centers are typically battling epidemics before such crises reach the level of national awareness – which is part of what makes them so effective. Private donations have also helped health centers stay afloat, a fact which was barely mentioned in the Washington Post/Kaiser reporting.

Savings for these centers do not mean that health center CEOs are enriching themselves. The average health center CEO salary is far less than what this reporting on outlier health centers would suggest. The truth is that there are far more profitable jobs in health care that do not
involve fighting for every dollar in order to care for the poor and underserved – particularly when compared to CEOs in the health care industry who earn salaries in the multiple millions of dollars. For health center staff, it’s about dedication, not dollars.

The Washington Post & Kaiser’s reporting, while omitting factual context, questions and amplifies misconceptions about the 340B prescription drug discount program – a program that has provided a crucial lifeline to uninsured and underinsured Americans who would otherwise
struggle to be able to afford lifesaving prescriptions. By law, any and all health center savings resulting from that program must be re-invested in patient care. As a result, health centers report vastly improved health outcomes among their patients. Transparency and accountability are also baked into the health center model, which makes some of the claims in the article so puzzling. Site visits by the Health Resources and Services Administration (HRSA) ensure that patient care, services provided, and clinical data is consistent with national standards. Additionally, health centers are governed by a local board, on which patients are the majority of directors. These boards have a vested interest in the results of the Operational Site Visits and are part of that process. Headlines aside, the health center model has been quietly addressing every public health crisis since it began as a small demonstration project more than 50 years ago. Even the Washington
Post/Kaiser reporting team calls their mission “a linchpin in the nation’s safety net for treating the poor.”

In a nation where most private practice physicians limit or do not accept any Medicaid patients, Community Health Centers are lifelines. Roughly half of all health center patients are covered by Medicaid and would, without access to health centers, likely seek a costlier service at a hospital emergency room. As we continue to struggle with the COVID-19 pandemic and other public health threats, health centers’ efforts to test, vaccinate, and treat hard-to-reach populations deserve support and investment.

The National Association for Community Health Centers will continue to stand up for our valued health care heroes who rise each day to create happier, healthier, and stronger communities throughout our country. No other health system in existence stands as a living legacy that health care can be patient-driven, effective, and trusted stewards of federal dollars.

We stand by this model.