Question from Senator Sanders:
Health centers save an incredible amount to the system each year. But where does the health system savings come from?
Panelist Dan Hawkins:
The savings come from the quality of the care, and the health improvements that people get. For children, health centers emphasize prevention, childhood checkups, immunizations, etc. For pregnant women, health centers provide comprehensive prenatal care, which lowers infant mortality rates by 40% in communities with a health center.
For people with chronic conditions, providers connect with people seeking care and educate them about self-management. Health centers show people how to measure their own indicators, how to control and manage their chronic conditions – and people come in for group visits and regular maintenance visits – to avoid the need for repeat services, specialty care, inpatient care, and take people out of the emergency room.
Panelist Cynthia Bascetta, GAO added two points:
1) The GAO found, recently, that health centers don’t provide chronic care management as well as some other systems, notably the VA. The GAO attributed this to just one key difference – the VA’s superior IT systems and infrastructure. The ARRA does provide those HIT incentives for health centers and Medicaid providers and, although it is not a cure-all, the IT support in the stimulus should give health centers the systems efficiencies they need to improve on all indicators.
2) The GAO reminds the Committee that prevention, from a system perspective overall, is not a panacea – while you can prevent certain diseases, people will develop other diseases later in life.
GAO’s Nota Bene: as health centers expand, Medicaid costs increase. This is not necessarily a bad thing, and we should focus on using health centers as a vehicle for our public programs – Medicaid and Medicare.
Panelist Dr. Fitzhugh Mullan added a point on the Corps:
Training doctors in Community Health Centers is critically important. Right now, one-quarter of 1% of physicians are in the National Health Service Corps, despite this program’s 30-year track record of proven effectiveness. As Senator Sanders proposes, NHSC needs to be taken out of the ‘experiment’ category and into the mainstream.
“Health Centers are health care, the way it ought to be.” — Dr. John Matthew