Community health centers (CHCs) are non-profit medical practices that provide comprehensive, cost effective, community oriented, assessible, patient centered, outcomes focused care. Currently there are 120 CHCsin Alabama providing primary care to almost 300,000 Alabamians. Community health centers have an overall economic impact of almost $150 million anually and employ 2,000 individuals statewide.
CHCs provide primary health care services in family practice, pediatricians, internal medicine, obstetrics, gynocology, and related diagnostic, treatment, consultative, referral, and other services rendered by physicians and mid-level providers. Additionally, CHCs provide comprehensive preventive health services such as medical social services, nutritional assessments and referrals, preventive health education, children's eye and ear examinations, prenatal services, well child care, immunizations, and voluntary family planning services. Many CHCs also provide dental and pharmacy services.
Characteristics of Community Health Center Services
Comprehensive
Through high quality, cost efficient care, CHCs reduce health disparities, improve birth outcomes, effectively manage chronic disease, and stimulate economic growth in the community. Through a “one-stop” primary care model, prevention, followed by services designed to ensure the effectiveness of the medical care provider, such as nutritional and health education and case management is fundamental its success. The Institute of Medicine specifically recognized the importance of CHCs stating that the CHC model has proven effective not only in increasing access to care, but also in improving health outcomes for the often higher-risk populations they serve.”
Cost Effective
Medicaid beneficiaries relying on CHCs for primary care are 19% less likely to use the ED for ambulatory conditions and 11% less likely to be hospitalized for an ambulatory condition. Annual medical expenses for CHC patients are 41% lower compared to patients seen elsewhere. In fact, a recent study on health centers, found the annual cost of treating a patient at a health center is less than the cost of one ED visit.
The White House Office of Management and Budgets rates community health centers as one of the top and most effective federal programs. Individuals who live near a community health center are less likely to have an unmet health care need, less likely to visit a costly emergency room or stay in the hospital, and are less likely to postpone or delay health care as compared to others with insurance. Shorter hospital stays and fewer emergency room visits keep everyone’s health care costs down.
Community Oriented
In the broadest sense, community health centers are providers of primary care to medically underserved populations. More specifically, community health centers, while focusing on improving the health of individual patients, strive to improve the health status of the entire community. This community oriented focus means community health centers differ from traditional health care providers in several ways. Needs assessments, program development, and evaluation are all framed in terms of both community health needs and individual patient health. The health center is accountable to the community which it serves by involving members and health center users in program planning and organizational governance.
Accessible
An accessible medical home is the most fundamental step in providing health care that is safe and efficient, effective, timely, equitable, and patient-centered. CHCs have traditionally overcome barriers to care because they are located in high-need communities, are open to all residents, offer services that facilitate access to primary care such as case management, transportation, outreach and health education. CHCs break down traditional barriers to health care in Alabama’s poorest communities by customizing their services to their communities’ unique cultural and health needs.
Individuals pay what they can afford for the care they need. Unlike other health care providers, community health centers charge patients who are not covered by insurance on a sliding fee scheduled based on their family size and income. CHCs bill Medicaid, Medicare, AllKids, and other private insurers for services provided to individuals with coverage. No one is turned away or denial primary medical care at a community health center based upon the inability to pay.
Patient Centered
Alabama’s community health centers provide comprehensive primary and preventive medical services including physician, dental, nurse, laboratory, x-ray, pharmacy, obstetrics, child and adult medicine, and specialty and inpatient referral and follow up. Most CHCs provide after hours and weekend hours to provide access to working families and individuals. Many operate centers to reach rural, homeless, and other special need populations.
Outcome Focused
Community health centers make a difference in the health status of their patients through better use of preventive care, management of chronic illness, a reduction in health disparities, and fewer infant deaths to infant mortality. The Institute of Medicine (IOM) and the US Government Accountability Office (GAO) cite community health centers as models for the nation in screening, diagnosing, and managing chronic conditions such as diabetes, cardiovascular disease, asthma, depression, cancer, and HIV/AIDS.