Community Health Center Patients Have Trouble Getting Specialty Care

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<p>Community health centers (CHCs) are a critical source of primary health care services for more than 15 million Americans in underserved communities, many of whom are poor and lack access to private insurance.<bR><br>Although the federal government recently increased the number of CHCs, there are concerns that these facilities lack the capacity to provide a full range of services to their patients. A Commonwealth Fund-supported study, <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=30384&return_url=http%3A%2F%2Fwww%2Ecommonwealthfund%2Eorg%2Fpublications%2Fpublications%5Fshow%2Ehtm%3Fdoc%5Fid%3D564080%26%23doc564080">Access to Specialty Care and Medical Services in Community Health Centers</a> (<em>Health Affairs,</em> Sept./Oct. 2007), reveals that CHC patients--particularly those who are uninsured or covered by Medicaid--have difficulty obtaining off-site specialty services, including referrals to medical specialists and mental health and substance abuse treatment.<Br><br>In interviews with medical directors of federally qualified CHCs, the research team, led by Nakela Cook, M.D., M.P.H., of Massachusetts General Hospital and Harvard Medical School, found that the most common barriers to care are providers' unwillingness to take Medicaid patients or those without insurance, the inability of patients to pay for services up front, and inadequate coverage for needed services.<br><br>The researchers say that one way of reducing barriers is to earmark additional funds for specialty services and to require off-site facilities deliver a defined amount of specialty care to patients referred from CHCs.</p>