Community health centers in Massachusetts saw a surge in patients after the state expanded health insurance coverage, indicating that the safety-net clinics remain a vital source of care even when people gain insurance, according to a study released today.
The report, published in the Archives of Internal Medicine, found that the number of patients treated at the health centers rose 31 percent from 2005 to 2009. During the same period, the percent of uninsured patients at the clinics declined from 35.5 percent to about 20 percent.
The 2010 federal health overhaul, which expands insurance coverage to more than 30 million people beginning in 2014, originally included $11 billion in new funding to expand community health centers, but Congress cut $600 million in April, and advocates fear more cuts could occur in efforts to reduce the federal deficit. “You have to be careful where you cut because cutting back on programs that are as efficient as community health centers will hurt taxpayers more in the long run,” said Dan Hawkins, senior vice president of the National Association of Community Health Centers.
Nationally, about 20 million Americans get care at 8,000 community health centers and the number of patients has been projected to nearly double by 2015.
After Massachusetts lawmakers expanded coverage in 2006, the uninsured rate in Massachusetts fell from 7 percent to 3 percent in 2009. In 2010, the uninsured rate was 1.9 percent, lowest in the country.
Nationally, about 38 percent of community health center patients are uninsured, according to data from the Association of Community Health Centers. About 37 percent of center patients participate in Medicaid, the state-federal health insurance program for the poor and disabled. About 15 percent have private insurance.
The study by researchers at George Washington University and University of Minnesota also found that outpatient visits to safety-net hospitals rose faster (9.2 percent) than non-safety net hospitals (4.1 percent) after Massachusetts expanded coverage. Safety net hospitals are those that get at least 20 percent of their revenue from treating the poor.
Leighton Ku, the lead author and professor of health policy at George Washington University, said the study found people like safety net facilities because of their convenience and affordability. “The presumption is safety net providers are providers of last resort when you are desperate, but that is not what their patients perceive,” he said. “They seem to like these places and do not feel the need to go elsewhere.”
Only 1 in 4 patients of community health centers or safety-net hospitals said they used the facilities because they had problems getting care elsewhere, the study found.
Ku said the findings highlight the need for additional government funding to community health centers to meet the expected surge in demand nationwide starting in 2014. But the study comes just four months after Congress reduced funding and as several states also reduced money to the centers.
The $600 million funding cut in April — enacted as part of a deal between Congress and the White House to fund federal spending for the current fiscal year — meant about 300 fewer health centers would be opened this year, said Hawkins. “This means 5 million fewer patients will be served this year and next and into the foreseeable future,” he added.