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Community health centers need help in meeting growing demand

By Rich Rinehart and Barry R. Niccolai 4 min read

Pennsylvania’s community health centers provide affordable quality health care, including primary medical, behavioral, and dental care, vision services, pharmaceutical services, and other critical health-enhancing services to 1 million Pennsylvanians annually in 54 counties through nearly 400 sites in underserved rural and urban areas.

Cornerstone Care, Inc. and Centerville Clinics, Inc. serve over 60,000 patients in Washington, Fayette, Greene, and Allegheny counties. Fayette and Greene Counties are two of the most economically challenged counties in the commonwealth. Community health centers serve all patients, regardless of their ability to pay. Patients face multiple barriers to accessing primary and preventative care on a timely basis, including transportation problems, lack of resources, lack of child care, lack of trust, inadequate health insurance or none at all, lack of access to information, and other reasons.

Community health centers are the largest network of primary health care providers in Pennsylvania. Cornerstone Care, Inc. and Centerville Clinics, Inc. provide a comprehensive array of care, including family medicine, pediatrics, dentistry, psychiatry, counseling, laboratory, pharmacy, optometry, and other specialty services at 27 locations in the region, as well as mobile services. A combined workforce of nearly 500 professional and support staff lives in our communities. Most of the doctors, dentists, counselors, and others would not be practicing in the region if not for these community health centers.

Both Cornerstone Care and Centerville Clinics are governed by volunteer boards, most of whose members are patients, and all of whom are from the communities where services are provided. They provide critical connections for prioritizing the needs of our communities. Both organizations partner extensively with public schools and community organizations to focus needed resources.

Gov. Josh Shapiro is rightly concerned about medical debt. Community health centers help to prevent debt by facilitating access to care early and preventing more costly problems. Moreover, the Congressional Budget Office has determined that community health centers relieve the public’s burden by saving at least $24 billion annually in other health care costs. The combined contribution to those savings by Centerville Clinics and Cornerstone Care is estimated to be between $55 and $80 million.

The profile of Pennsylvanians who receive care at community health centers includes:

88.35% are at or below 200% of the Federal poverty level.

13.06% are uninsured – a number expected to grow due to resumption of pre-pandemic Medicaid rules and resulting loss of coverage.

48.57% are Medicaid- or CHIP-insured.

2.86% are homeless.

However, community health centers across Pennsylvania are struggling with narrowing margins and increased costs throughout their organizations. They must cover the costs of caring for the uninsured, often inadequate Medicaid reimbursement, and the costs of necessary but unreimbursed services to help the patients they serve get well and stay well and not require higher cost emergency room or hospital care. Covering the costs of care and ensuring access to care have become even more challenging because of increases in the price of goods, services, and workforce, as well as diminished revenue from other funding sources that were created to help safety net organizations like community health centers to stretch scarce resources.

For the first time, Pennsylvania’s community health centers are asking for help from Shapiro and the Legislature in the 2024-25 state budget to assist in covering the costs of providing care to uninsured Pennsylvanians and to assist in covering additional unfunded costs, such as community health workers, transportation, care coordination, technology costs, and more. Pennsylvania, along with only three other states, does not financially support this critical safety net and we can no longer carry this burden alone.

According to a Matrix Global Advisors analysis, which quantifies the direct and indirect economic impact of community health centers in Pennsylvania, these centers supported more than 13,000 jobs, nearly $2.4 billion in economic output, and almost $980 million in labor income in 2021. The Federal Congressional Budget Office recently noted that “evidence suggests that such care leads to more cost effective care and ultimately to lower federal spending for the Medicaid and Medicare populations they serve; the use of health care provided by community health centers generally is associated with lower spending in emergency departments, in inpatient hospital settings, and for other outpatient services.”

Community health centers couldn’t do what they do – and collectively what they do is provide 3.6 million individual patient visits every year for health services – without all the great people who work in them and without the funding necessary to keep them open. Community health centers for more than 50 years have had bipartisan support at the federal level. We are counting on similar support in Pennsylvania because we know that health is the greatest wealth.

Rich Rinehart is the CEO of Cornerstone Care and the chair of the Pennsylvania Association of Community Health Centers.

Barry R. Niccolai is the CEO of Centerville Clinics, Inc., and secretary of the Pennsylvania Association of Community Health Centers

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