America’s network of community health centers is facing a siege on three fronts: a surge in patients, a shortage of doctors and the related — and largely preventable — epidemics of obesity and type 2 diabetes. The good news is the nation’s leading institutions have the capacity to aid and provide critical reinforcements to protect this cornerstone of our health system.
By 2015, the Affordable Care Act could nearly double the case load of the nation’s community health centers — which currently serve more than 20 million people in some of our most vulnerable communities. This increased need will collide with a growing drought in the country’s supply of primary-care physicians, a shortfall projected to reach 63,000 by 2015. Worse, the rates of obesity and diabetes — preventable conditions with devastating health and financial impacts — continue to explode, often disproportionately in the same communities dependent on community health centers for care.
These clinics provide a critical safety net of services — including preventive care, screenings, disease management and urgent care — to millions of people in underserved communities who may otherwise not be able to afford it. That’s good news for the 26 million Americans living with diabetes and another 79 million with pre-diabetes and at grave risk for developing type 2 diabetes. This form of diabetes is one of the most prevalent chronic diseases among low-income patients, making health centers an especially critical resource in the fight against a growing epidemic.
Despite limited resources, with financial support from government and private institutions, community health centers are proven innovators when it comes to chronic disease management, helping patients to better understand and manage serious and costly conditions like diabetes and heart disease.
A prevention-focused, patient-centered approach has been proven to improve care delivery, health outcomes and cost savings. According to a recent Forbes article, it costs just over $600 per year to provide comprehensive primary care to a patient in a community health center, compared with nearly $1,000 in other physician settings. The National Association of Community Health Centers estimates this community-based model generates $24 billion in healthcare system savings each year. Research also shows these clinics save the Medicaid program as much as 30 percent annually.
Until recently, these results have helped this network grow in strength and number. Since the nation’s first community health center opened in 1965, expansion of this federally supported system to 1,200 organizations nationwide has helped millions of families each year receive high-quality and affordable health care.
Unfortunately, $600 million in funding for these centers was recently cut from the federal budget. At the same time, some states facing tough budget choices are dropping funding for community health centers. These cutbacks, and the threat of additional ones in the coming years, could undermine these clinics’ ability to meet the health needs of our nation’s communities, with drastic health and economic consequences for everyone.
America’s growing — and increasingly strategic and impactful — social responsibility movement has the potential to provide these community health centers — and the people they serve — with the support they so desperately need.
For example, United Health Foundation, a private foundation established by UnitedHealth Group, has committed a $1 million gift renewal to the University of Miami’s Miller School of Medicine’s Department of Family Medicine and Community Health. These funds will go directly to help increase access to and improve the quality of health care for the more than 6,000 people who receive care eachyear at the Jefferson Reaves, Sr. Health Center in Miami’s Overtown neighborhood.
The funding has supported the work at the center to help thousands of patients better manage serious conditions like diabetes.
For decades, community health centers have helped shield and strengthen communities in need, but today, they are facing formidable challenges with inadequate defenses. Without strong and continued support from government, the private sector and philanthropic organizations, our community health centers could face a crushing blow.
Dr. Robert Schwartz is professor and chair of the Department of Family Medicine and Community Health at the University of Miami Miller School of Medicine. Dr. John G. Ryan is Associate Professor of Family Medicine at the Miller School of Medicine and director of the United Health Foundation-funded Community Health Center of Excellence program.