Estimating the Effects of Health Reform on Health Centers\u27 Capacity to Expand to New Medically Underserved Communities and Populations

Nearly 100 million persons reside in urban and rural communities that can be considered medically underserved as a result of inadequate supply of primary care physicians and elevated health risks. A report by the National Association of Community Health Centers and the Robert Graham Center estimated that 60 million people are medically disenfranchised and lack access to adequate primary health care because of where they live, even though many have health insurance. This brief assesses the potential effects of national health reform on health centers and on the number of patients they can serve. Because improving primary care access is regarded by experts is key to the success of health reform, a critical question is how the proposals before Congress would address health centers\u27 ability to expand the availability of primary care in communities across the country. This Brief examines the effects of the draft House Tri-Committee (Energy and Commerce, Education and Labor and Ways and Means Committees) health reform bill, as issued July 14, 2009

Using Primary Care to Bend the Cost Curve: The Potential Impact of Health Center Expansion in Senate Reforms

This analysis of reforms being considered in the United States Senate reaches conclusions similar to those of our prior analyses of reforms being considered in the House of Representatives. The combination of expanded health insurance coverage and investments in the expansion of community health centers can produce substantial long-term savings both for the overall health care system and for the federal government. Our analysis of the Senate provisions from the HELP and Finance Committees estimates $369 billion in total medical savings, including$105 billion in federal Medicaid savings. The Senate provisions produce larger savings because they authorize larger funding increases for federal health center grants and provide for the use of the prospective payment system for health center payments under health insurance exchange plans. However, it is important to note that, although both the Senate and House bills authorize increased health center appropriations up to certain levels, the House bill also creates a mandatory trust fund which can be tapped for health center appropriations, increasing the likelihood that actual appropriations would reach the levels authorized in the bills

Who Are the Health Center Patients Who Risk Losing Care Under the House of Representatives\u27 Proposed FY 2011 Spending Reductions?

On February 20, 2011, the United States House of Representatives approved more than $61 billion in discretionary spending reductions for the remainder of FY 2011. The legislation includes$1.3 billion in direct spending cuts for community health centers. Using the NACHC patient estimates, we present evidence on the characteristics of patients whose continuing access to health center services is at risk. We arrived at these estimates using data from the Uniform Data System (UDS), the federal reporting system in which all health centers must participate, as well as national estimates from the Medical Expenditure Panel Survey (MEPS), and published reports on the health status of low-income populations

Promoting the Integration and Coordination of Safety-Net Health Care Providers Under Health Reform: Key Issues

The Affordable Care Act includes several provisions designed to encourage greater coordination and integration among health care providers, including the promotion of accountable care organizations and health homes. While much discussion has focused on how these strategies might be adopted by Medicare and private insurers, little attention has focused on their application among safety-net health care providers. Such providers face particular challenges in coordinating care for their low-income and uninsured patients, and no single approach is likely to meet their diverse needs. Successful efforts will require federal, state, and local financial resources to sustain the safety net and make the investments needed to upgrade capabilities. In addition, they will require flexible strategies that can accommodate variations in community and state needs

Promoting the Integration and Coordination of Safety-Net Health Care Providers Under Health Reform: Key Issues

The Affordable Care Act includes several provisions designed to encourage greater coordination and integration among health care providers, including the promotion of accountable care organizations and health homes. While much discussion has focused on how these strategies might be adopted by Medicare and private insurers, little attention has focused on their application among safety-net health care providers. Such providers face particular challenges in coordinating care for their low-income and uninsured patients, and no single approach is likely to meet their diverse needs. Successful efforts will require federal, state, and local financial resources to sustain the safety net and make the investments needed to upgrade capabilities. In addition, they will require flexible strategies that can accommodate variations in community and state needs

Highlights: Analysis of the Proposed Rule on Designation of Medically Underserved Populations and Health Professional Shortage Areas

For decades, the federal government has targeted health care funding, resources and staff to meet the health care needs of areas designated as medically underserved areas and health professional shortage areas. Areas that qualify may, for example, receive federal funding to support the establishment and operation of community health centers, or receive National Health Service Corps (NHSC) physicians and clinicians. In addition, physicians who practice in these health shortage areas may receive higher payments under Medicare. These designations thus affect the availability of health care in thousands of urban and rural areas all across the United States. Community health centers provide care for more than 16 million patients

Analysis of the Proposed Rule on Designation of Medically Underserved Populations and Health Professional Shortage Areas

Numerous safety net programs and health care providers depend on Medically Underserved Area and Population (MUA/P) and Health Professional Shortage (HPSA) designations to qualify for federal funding, physician subsidies and placement, and health-related investments to improve access to care for communities and populations at high risk of poor health. These resources are particularly critical for federally-qualified health centers at a time when the number of uninsured is growing and the capacity of the safety net shrinking. On February 29, 2008, the Department of Health and Human Services (HHS) released a proposed regulation to alter the way these designations are made. This report provides the first up-to-date analysis of the effects of the new regulations; the impact analysis contained in the Federal Register notice was based on 1999 data, while this one uses data from 2005

Boosting Health Information Technology in Medicaid: The Potential Effect of the American Recovery and Reinvestment Act

The American Recovery and Reinvestment Act of 2009 (ARRA) will invest approximately $49 billion to expedite health information technology (HIT) adoption through Medicare and Medicaid. Our analysis of 2006 NAMCS data found that approximately 15 percent of the practicing office-based physicians in the country would qualify for up to$63,750 over six years in Medicaid financial incentives for HIT adoption. Included within the 45,000 eligible physicians are about 99 percent of all community health center physicians. If all qualifying physicians apply for the Medicaid incentives and receive the maximum level of payments, the federal government would invest more than $2.8 billion in HIT

Reference-free polarization-sensitive quantitative phase imaging using single-point optical phase conjugation

We propose and experimentally demonstrate a method of polarization-sensitive quantitative phase imaging using two photodetectors and a digital micromirror device. Instead of recording wide-field interference patterns, finding the modulation patterns maximizing focused intensities in terms of the polarization states enables polarization-dependent quantitative phase imaging without the need for a reference beam and an image sensor. The feasibility of the present method is experimentally validated by reconstructing Jones matrices of several samples including a polystyrene microsphere, a maize starch granule, and a mouse retinal nerve fiber layer. Since the present method is simple and sufficiently general, we expect that it may offer solutions for quantitative phase imaging of birefringent materials