Community health centers continue to see huge demand for services

Patient visits to community health centers surged from 2010 to 2016, highlighting the continued need for the healthcare safety net despite greater access to insurance, according to a research released Thursday.

Although the Affordable Care Act and Medicaid expansion helped more people gain insurance coverage, community health centers have seen a 33% upswing nationwide in patient visits between 2010 and 2016, according to an analysis published this week by researchers at George Washington University's Milken Institute School of Public Health.

The trend varied from state to state. Some, like Indiana and Louisiana, saw as much as an 83% and 86% increase in their number of community health center patients, while Mississippi and Wyoming experienced declines of 6% and 15%.

Expansion states had the biggest increase in community health center patients, adding more than 4.8 million visits, or a 37% uptick. Non-expansion states added more than 1.5 million visits, resulting in a 26% increase.

Experts believed that community health center use would decline as more individuals obtained insurance. The findings may indicate that community health center patients have limited choices to access care, and insurance coverage alone won't solve that issue.

"This adds further evidence that having health insurance is of course a critical foundation in access to care, but you have to accompany the insurance coverage with a well-designed effort to raise the supply of accessible services in communities that are medically underserved and can't on their own attract physicians and providers," said report co-author Sara Rosenbaum, a professor of health law and policy at George Washington University.

Considered by many to be the backbone of the nation's healthcare safety net, community health centers primarily service medically underserved areas and provide care regardless of a person's ability to pay.

Nearly 26 million patients received care at a community health center in 2016, according to the Kaiser Family Foundation. Of those patients, nearly half were covered by Medicaid and 23% were uninsured.

Many community health centers have experienced extensive growth since the administration of President George W. Bush and that trend accelerated throughout the Obama administration, which provided billions in capital funding through the ACA's Community Health Center Fund. The fund has been credited with opening 950 community health center sites since 2010.

But many community health centers were under threat of cutting staff, services or closing sites altogether after lawmakers missed the Sept. 30, 2017 deadline for re-authorizing funding for the Community Health Center Fund.

Congress didn't approve the funding for another six months. Funding was eventually restored as part of the omnibus spending deal agreed upon in February.

Rosenbaum hoped the findings would remind policymakers of the centers' importance and spur them to avoid similar inaction when the Community Health Center Fund needs to be re-authorized after 2019.

"The fact that a true crisis on a national level was averted hopefully does not serve as green light to treat future financing this way," Rosenbaum said.