Access to Care and the Economic Impact of Community Health Centers
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1 Access to Care and the Economic Impact of Community Health Centers National Congress on the Un and Underinsured Monday, December 10, :30-4:30 The Robert Graham Center
2 Community Health Centers What are health centers? Whom do they serve? How do health centers overcome barriers to care? How do health centers make a difference? Why is investing in health centers important?
3 Health Centers: History and Purpose Founded in 1965, through civil rights & war on poverty movements to address needs of poor & minorities Two-fold purpose Be Agents of Care in areas with too little of same Be Agents of Change, giving communities a role Today: 1150 Health Center organizations Located in every state and territory More than 6,300 health care delivery sites, 600 of them school-based, plus additional mobile clinic, shelter, and labor camp sites
4 Health Centers Today Health care home for over 17 million Americans 1 of 5 Low-income Uninsured Persons 1 of 8 Medicaid/CHIP Recipients 1 of 4 Low-Income, Minority Individuals 1 of 5 Low-Income, Uninsured Individuals 1 of 9 Rural Americans 923,400 Farmworkers, 940,000 Homeless Persons
5 Overcoming Barriers to Care Key features of health centers: Location in high-need areas Open to everyone regardless of ability to pay Offer comprehensive health and related services (especially enabling services) Tailor services to meet specific community needs (HIV, mental health, linguistic/cultural appropriateness) Governed by community boards, to assure responsiveness to local needs
6 How Health Centers Make a Difference Independent evaluations of centers find: Excellent Quality of Care: More Effective Care, Better Use of Preventive Care, Fewer Infant Deaths Major Impact on Minority Health: Significant Reductions in Disparities for Health Outcomes, Receipt of Preventive and Condition-Related Care Higher Cost-Effectiveness: Lower Overall Costs, Lower Specialty Referrals and Hospital Admissions, Substantial Medicaid Savings Significant Community Impact: Employment and Economic Effects, Contribution to Community Well- Being, Development of Community Leaders
7 The Access for All America Plan Grow health centers program to serve 30 million people by 2015 by Developing new CHC sites and expanding existing sites Funding every health center for oral and mental health, and for pharmacy services Increasing workforce training programs (especially NHSC) to build primary care workforce for all Increasing support for new facilities, equipment, HIT, and quality/performance improvement Maintaining Medicaid and SCHIP coverage, and expanding it wherever possible
8 Who and How Many Need Care Americans of all income levels, race and ethnicity, and insurance status have inadequate access to a primary care physician 56 million Americas are medically disenfranchised
9 No Usual Source of Care Nearly 1 in 5 (19.3%) Americans (55.5 million people) reported lacking a Usual Source of Care same as our medically disenfranchised number; Of those without a USC, 32% are uninsured and 21% are low income; 52% of all uninsured people under 65 years of age have no USC; Nearly a quarter (24%) of all poor or near-poor are without a USC; and 32% of all Hispanic or Latino Americans have no USC 23% of all Black,non-Hispanic people have no USC Source: 2004 Medical Expenditure Panel Survey
10 Map 1 Percent of Medically Disenfranchised By State, 2005 DE DC National Average = 19.4% 40% or greater % % Less than 9.9% Note: Does not subtract health center patients as state and U.S. medically disenfranchised figures do. Source: The Robert Graham Center. Health Services and Resource Administration (HPSA, MUA/MUP data, 2005 Uniform Data System), 2006 AMA Masterfile, Census Bureau 2005 population estimates, NACHC 2006 survey of non-federally funded health centers.
11 No State is Immune 21 States each have more than one million medically disenfranchised residents. Florida, Texas, and California together make up 29% of the 56 million 2 in 5 residents in nine states have threatened or limited access to basic health care. 55.9% of Alabama residents are medically disenfranchised.
12 The Primary Care Payoff American currently spends $2 trillion health care. Health centers generate substantial savings Americans could potentially save the health care system $67 billion.
13 CHCs and Hospitalizations Average annual cost reduction of $1,810 (median reduction ($959) = 41% reduction Average annual cost reduction for Medicaid $996 (median reduction $399) Source: 2004 Medical Expenditure Panel Survey
14 CHCs and ED visits For Medicaid beneficiaries, 35.5% relative reduction in ED visits 37% reduction for Blacks CHCs may facilitate more appropriate ED use for uninsured and poor Source: 2004 Medical Expenditure Panel Survey
15 Health Center Savings Health Centers generate between $9.9 and $17.6 billion. By 2015, health centers would generate at least $22.6 billion, and as much as $40.4 billion.
16 Health Center Economic Benefits Impact on predominantly low-income communities served: Health center spending that flows to/through communities Employment of local residents Businesses in community that benefit from health center s presence (directly and indirectly)
17 Methods IMPLAN (Impact analysis for PLANning) complete economic planning tool. IMPLAN s output, earnings, and employment figures are aggregated based on the following: Direct effects Indirect effects Induced effects
18 Table 1 Total Economic Activity Stimulated by Federally-Funded Community Health Centers Operations, 2005 Total Economic Impact Employment (Full Time Equivalents) Direct $7,261,975,096 89,922 Indirect $1,124,387,922 10,233 Induced $4,172,328,893 42,918 Total $12,558,691, ,073 Note: Total Economic Impact includes Value-Added Impact. For an explanation, see Appendix B. Payroll (Value-Added), estimated at 73% of Operating Expenditures, is based on Capital Link s financial database Fiscal Year 2005 median value for health centers nationally. Each Full Time Equivalent (FTE) denotes one full time employee. Total FTEs denote total workforce generated by health centers. For the definition of FTE, see Appendix B. Source: Capital Link, Inc with MIG, Inc. IMPLAN Software Pro version and 2004 structural matrices with the 2002 state level multipliers. Direct CHC Operating Expenditures derived from Bureau of Primary Health Care, HRSA, DHHS, 2005 Uniform Data System.
19 Table 2 Total Economic Activity Stimulated by an Average Large Urban and Small Rural Health Center, 2005 Large Urban Health Center Small Rural Health Center Total Economic Impact Employment (Full Time Equivalents) Total Economic Impact Employment (Full Time Equivalents) Direct $ 12,252, $ 3,333, Indirect $ 2,273, $ 261,600 3 Induced $ 7,114, $ 287,124 4 Total $ 21,640, $ 3,882, Note: Total Economic Impact includes Value-Added Impact. For an explanation, see Appendix B. Actual health center with an annual budget of $12.3 million (large) and $3.3 million (small), based on Capital Link s financial information database. Each Full Time Equivalent (FTE) denotes one full time employee. Total FTEs denote total workforce generated by health centers. For the definition of FTE, see Appendix B. Source: Capital Link, Inc with MIG, Inc. IMPLAN Software Pro version and 2004 structural matrices with 2004 county level multiplier. Direct CHC Operating Expenditures derived from Fiscal Year 2005 audited financial statements.
20 Table 3 Health Center Economic Impact by State, 2005 Alabama $ 121,382,364 Kentucky $ 145,069,297 North Dakota $ 14,662,971 Alaska $ 144,528,348 Louisiana $ 78,432,187 Ohio $ 232,736,644 Arizona $ 286,830,888 Maine $ 95,132,259 Oklahoma $ 59,581,749 Arkansas $ 78,795,465 Maryland $ 201,502,347 Oregon $ 292,735,806 California $2,037,609,155 Massachusetts $ 610,958,760 Pennsylvania $ 337,934,781 Colorado $ 373,364,151 Michigan $ 323,832,254 Rhode Island $ 67,410,498 Connecticut $ 199,959,243 Minnesota $ 127,925,653 South Carolina $ 201,023,876 Delaware $ 15,092,736 Mississippi $ 148,879,146 South Dakota $ 33,223,901 District of Columbia $ 71,586,512 Missouri $ 278,798,343 Tennessee $ 171,825,379 Florida $ 537,168,777 Montana $ 44,619,157 Texas $ 560,203,991 Georgia $ 163,682,141 Nebraska $ 34,274,030 Utah $ 60,401,822 Hawaii $ 117,206,087 Nevada $ 33,600,556 Vermont $ 34,069,199 Idaho $ 64,286,155 New Hampshire $ 59,285,597 Virginia $ 143,116,890 Illinois $ 658,087,959 New Jersey $ 225,955,243 Washington $ 610,452,536 Indiana $ 123,745,679 New Mexico $ 192,466,789 West Virginia $ 294,209,387 Iowa $ 77,082,402 New York $ 1,143,732,348 Wisconsin $ 229,500,072 Kansas $ 35,089,879 North Carolina $ 203,433,165 Wyoming $ 18,383,772 United States $ 12,558,691,991 Source: NACHC, Access Granted: The Primary Care Payoff,
21 Future Impact Federally qualified health centers could serve 30 million patients by The estimated operating expenditures is $23.5 billion. Projected expenditures - an estimated total economic impact of $40.7 billion. Creating more than 460,000 full time equivalent jobs in 2015.
22 Challenges Ahead Expansion Investment Workforce
23 For More Information Contact: Dan Hawkins Bob Phillips Falayi Adu View Both Access Denied and Access Granted at:
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