Bringing public health, hospitals, mental health, and community health centers together.
Community Health Centers
As a best practice, hospitals, public health and mental health should have a federally qualified health center (FQHC) partner. Within constraints of anti-trust laws concerning primary care, chronic care and mental health services, hospitals and FQHCs should work together to get patients into medical homes and out of hospital emergency rooms (ERs).
Sharing State’s Burden on Uncompensated Care
Mississippi data from the 2018 Uniform Data System (UDS) showed that Mississippi Community Health Centers provided an astounding $52,373,521 in sliding fee discounts to medically indigent patients, represendingan increase from $51,157,795 in 2017.
Value-Based Care Population Health
Health centers and Medicaid work together to provide coverage and access for some ofthe most vulnerable Americans. Health centers are the health care home for more than 25 million patients, 49% of whom are covered by Medicaid. Nationally, health centers care for more than 1 in 6 of all Medicaid beneficiaries.
Health centers save the Medicaid program $6 billion annually and an estimated $216,786,500 in Mississippi and health center patients with Medicaid have lower utilization of costly hospital and emergency department-related services compared to patients at other providers. A recent landmark study of 13 states found that health centers save Medicaid, on average, $2,371 (or 24%) per year in total cost of care when compared to other providers.
Congress recognized the vital role of health centers within Medicaid by creating a unique prospective payment system that ensures predictability and stability for every health center while saving Medicaid money overall. Even without any reduction to Medicaid benefits and eligibility, eliminating this payment system alone would result in a loss of roughly 30% of health centers’ Medicaid revenue nationwide – for many health centers, the figure could be even higher.
In 2018, CHCs have approximately 17,000 atttributed Medicare lives and saved the Center for Medicaid Services (CMS) $6,472,274. Mississippi CHCs serve more than 95,000 Medicaid beneficiaries, which is 31% of all patients served by health centers. Health centers are also cost-effective Medicaid providers, serving 13% of all Medicaid beneficiaries in our state but representing less than one percent of the state’s total Medicaid expenditures.
Quality Scores among FQHC participating in Accountable Care Organizations (ACOs) exceed benchmarks and validate more accountable care: lower, cost-improved quality.
Collective Impact #1
Need fuel for real-time surveillance of cross-sector data, which is what statewide Health Information Exchange (HIEs) provide; where partnerships prevail over duplication of effort and where the state public health agency becomes the catalyics point for data and action.
Collective Impact #2
If FQHCs, hospitals, and public health had acces to this information collectively, partners could drill down to reduce frequent flyers and high cost drivers of the delivery system. It’s the beginning of what moves us toward population health and evidence of impact among social determinants.
Such efforts, with state support and investment, could posture us for broader health promotion and education, true medical home models, and mitigating future hemorrhaging of rural hospitals.
Provider-Sponsored Health Plan
Opportunities with FQHCs:
- Improved credentialing
- Case management
- HIE development
Maternal and Child Health
Public health has historically provided over 50% of prenatal care to underserved women. In 2017, they discontinued services statewide. CHCs continue to fill most of this pag per HRSA, the MCH funding for Mississippi in 2018, which has not declined. Total funding: $17,470,091