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Access to Care and the Economic Impact of Community Health Centers. National Congress on the Un and Underinsured Monday, December 10, 2007 3:30 - 4:30 . The Robert Graham Center. Community Health Centers. What are health centers? Whom do they serve? - PowerPoint PPT Presentation
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Access to Care and the Economic Impact of Community Health
Centers
The Robert Graham Center
National Congress on the Un and Underinsured
Monday, December 10, 2007
3:30 - 4:30
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?
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
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
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
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
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
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”
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
40% or greater
20 - 39.9%
19.9 -10%
Less than 9.9%
Map 1Percent of Medically Disenfranchised By
State, 2005
DC
National Average = 19.4%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.
DE
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.
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.
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
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
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.
Health Center Economic Benefits
Impact on predominantly low-income communities served:Health center spending that flows to/through
communitiesEmployment of local residentsBusinesses in community that benefit from
health center’s presence (directly and indirectly)
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
Table 1Total 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 $12,558,691,911 143,073Note: 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 2.0.1025 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.
Table 2Total 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 $ 12,252,801 187 $ 3,333,321 45
Indirect $ 2,273,314 24 $ 261,600 3
Induced $ 7,114,112 70 $ 287,124 4
Total $ 21,640,227 281 $ 3,882,045 52
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 2.0.1025 and 2004 structural matrices with 2004 county level multiplier. Direct CHC Operating Expenditures derived from Fiscal Year 2005 audited financial statements.
Table 3Health 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 $ 12,558,691,991Source: NACHC, Access Granted: The
Primary Care Payoff, 2007 www.nachc.com/research
Future Impact Federally qualified health centers could
serve 30 million patients by 2015.
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.
Challenges Ahead
Expansion Investment Workforce
For More InformationContact:
Falayi [email protected]
View Both Access Denied and Access Granted at: www.nachc.com/research