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Centers Claim Big Savings from Delivering Primary Care

By John Reichard, CQ HealthBeat Editor

August 6, 2007 – The lobby that represents community health centers made a pitch Monday for legislation sharply increasing federal funding for those facilities, saying they offer a brand of health care far less costly than what's given in traditional doctors' offices. Primary care services provided by the centers result in per-patient medical expenses 41 percent lower than for patients seen in other settings, said a study released by the National Association of Community Health Centers.

"These savings occur despite the fact that health center patients are more likely to be poor and uninsured or publicly insured than patients relying on other health care providers," said the authors of the study, which included the Robert Graham Center, a research arm of the American Academy of Family Physicians, and Capital Link, a Washington, D.C. consulting firm.

Per-patient costs averaged $2,569 in 2004 compared with $4,379 for patients treated elsewhere—a difference of $1,810. The figures included expenditures for office visits, drugs, emergency care, other hospital care, and out-of-pocket health care spending, said the authors of the study.

Community health centers are typically located in poor areas and take patients regardless of their ability to pay. They treat a mix of uninsured patients, Medicaid patients, and other patients who have coverage, which is often meager.

In a telephone press briefing, Virgilio Licona, a physician with a community health center in Colorado, gave an example of the type of care delivered by the facilities. He described an obese patient he began treating last week who has diabetes, high blood pressure, high cholesterol, and who "is somewhat depressed." It's likely that over the next six to nine months, because of the diabetes education program, behavioral health services, and medications provided by the facility, the patient will lose weight, have her blood pressure under control, and have lower cholesterol levels, Licona said. The mix of primary care services heads off costly complications leading to emergency room and other expensive hospital-based treatment, according to the study.

Americans often are without such a "family-centered medical home," which if applied widely, would save tens of billions of dollars annually, the association said.

The federal government now spends some $2 billion a year on community health centers that treat about 16 million people; if funding were increased to $5 billion a year by 2015, the health care system would save between $23 billion and $40 billion annually, said Dan Hawkins, senior vice president for policy at that association.

According to the study, the number of jobs produced by community health centers would increase from 143,000 now to 460,000 in 2015 if annual funding were boosted to $5 billion. The figures take into account direct employment as well as indirect economic effects, such as goods and services purchased by centers from local businesses and the jobs those acquisitions help to fund.

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