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Federally Qualified Health Centers

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Happier days at FQHCs

August 25, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

The big increase in support for Federally Qualified Health Centers (FQHCs), which have received considerable bipartisan support over the years, has brought big smiles to FQHC leaders and patients who had feared that congressional gridlock would jeopardize the whole program.

The health centers have become the largest single primary-care system in the United States.

The Department of Health and Human Services will  distribute $169 million provided by the Affordable Care Act to open 266 new health centers in 46 states, the District of Columbia and Puerto Rico. That’s in addition to 700 new health centers opened  because of the Affordable Care Act.

The program seems safe at least through fiscal 2017 and probably indefinitely beyond.

A pediatrician looks back at his FQHC years

July 20, 2015by Robert Whitcomb in Uncategorized tagged , , , ,

 

Peter Simon, M.D., a pediatrician also known as Dr. Martes, or Dr. Tuesday, has hung up his stethoscope after 30 years of practicing one evening a week at the Providence Community Health Centers, beyond his day job at the Rhode Island Department of Health. In the latter job he  served most recently as the medical director of the Division of Community, Family Health and Equity, before retiring, in 2013.

His review gives a strong sense of the professional satisfactions of serving in Federally Qualified Health Centers.

He told ConvergenceRI that “some have to do with the challenges and rewards of practicing medicine cross-culturally.

“Others include the pleasure of interacting with so many wonderful healthcare workers and physicians.”

Cambridge Management Group at 30

July 9, 2015by Robert Whitcomb in Uncategorized tagged , ,

Cambridge Management Group is (quietly) celebrating its 30th anniversary this month. Since 1985, our firm, composed of senior professionals with many years of business and clinical experience from across America — has been privileged to help organizations adapt to healthcare-sector-wide changes while addressing individual organizations’ often unique challenges.

The sector has seen vast changes since 1985! Consider the arrival of various forms of managed care, the rise of big hospital chains and the surge in hospital employment of once-independent physicians. Then there are the stunning new technologies that can turn patients into amateur doctors and new government insurance programs aimed at expanding coverage while controlling costs. The Affordable Care Act has, of course, accelerated the sector’s transformation in the past several years.

During the past three decades, CMG has expanded from consulting at hospitals to also work for a wide range of other healthcare organizations, such as Federally Qualified Health Centers and statewide Medicaid programs as “population health’’ becomes a mantra.

Whatever the challenges along the way, we’re always energized by our mission, as summarized in our motto “Cooperating for Better Care’’. To us at CMG, healthcare remains the most exciting – and, arguably, the most important — place to work. We’re grateful to have had the opportunity to do so for three decades, and look forward to continuing for years to come.

Cambridge Management Group at 30

July 7, 2015by Robert Whitcomb in Uncategorized tagged , , , , ,

 

Cambridge Management Group is (quietly) celebrating its 30th anniversary this month. Since 1985, our firm, composed of senior professionals with many years of business and clinical experience from across America — has been privileged to help organizations adapt to healthcare-sector-wide changes while addressing individual organizations’ often unique challenges.

The sector has seen vast changes since 1985! Consider the arrival of various forms of managed care, the rise of big hospital chains and the surge in hospital employment of once-independent physicians. Then there are the stunning new technologies that can turn patients into amateur doctors and new government insurance programs aimed at expanding coverage while controlling costs. The Affordable Care Act has, of course, accelerated the sector’s transformation in the past several years.

During the past three decades, CMG has expanded from consulting at hospitals to also work for a wide range of other healthcare organizations, such as Federally Qualified Health Centers and statewide Medicaid programs as “population health’’ becomes a mantra.

Whatever the challenges along the way, we’re always energized by our mission, as summarized in our motto “Cooperating for Better Care’’. To us at CMG, healthcare remains the most exciting – and, arguably, the most important — place to work. We’re grateful to have had the opportunity to do so for three decades, and look forward to continuing for years to come.

The big get bigger

July 3, 2015by Robert Whitcomb in Uncategorized tagged , , , , , , ,

bigfish

Aetna’s planned  $37 billion purchase of rival  Humana, which would make Aetna the biggest health insurer, would accelerate the consolidation of health systems as hospitals seek more leverage in negotiating with insurers  whose increasing size gives them vast negotiating power.

The deal would make Aetna a major player in the surging Medicare Advantage business and  would bolster Aetna’s presence in   Medicaid and in Tricare coverage for military personnel and their families. But everyone in the healthcare sector  would be affected,  directly or indirectly, including Federally Qualified Health Centers.
Modern Healthcare noted that Aetna’s  announcement came  a day after the Medicaid coverage provider Centene said it would buy fellow insurer Health Net to  help Centene expand in  the California Medicaid market, the nation’s biggest, and give it a Medicare presence in several other western states.
As private-sector-employer-based insurance has shrunken, the big insurers are  expanding into public programs at an ever faster clip.

 

 

 

 

Calif. primary care for illegal aliens

June 29, 2015by Robert Whitcomb in Uncategorized tagged ,

 

The California County Medical Services Program, which provides healthcare coverage for indigent adults in 35 rural California counties, has voted  to offer primary care to undocumented immigrants.

The Los Angeles Times reports that the news means that “Now 47 of the state’s 58 counties will provide some form of low-cost medical care to undocumented immigrants….This covers nearly half the state’s geography, primarily in the northern part of the state, but also in Imperial County, which borders Mexico. Some urban counties such as Los Angeles, Ventura and San Francisco, already provide healthcare to undocumented immigrants.”

The state’s many Federally Qualified Health Centers will presumably be called upon to treat many of these new, illegal-alien patients.

 

 

FQHC’s brace for Scotus ruling

June 14, 2015by Robert Whitcomb in Uncategorized tagged , , , ,

America’s 1,200 Federally Qualified Health Centers would be hit hard by a possible U.S. Supreme Court ruling this month eliminating health-insurance premium subsidies for federal exchange-plan enrollees. Modern Healthcare reports that  leaders of  some of these clinics say they’d have to provide far more uncompensated care if the Supremes throw out subsidies.
“Given the shortage of primary-care physicians, community health centers have been key primary-care providers for Americans who have received expanded private and Medicaid coverage under the Affordable Care Act,” the publication noted.
With the subsidies gone,  the centers “could draw a line and say they simply don’t have the resources to serve any more people,” Dan Hawkins, policy director of the National Association of Community Health Centers, told the publication.
Many FQHC’s have already been hit by declines in state funding.
“More broadly, a ruling striking down the subsidies would set back many years of efforts by presidents and congressional leaders of both parties to expand healthcare access to low-income Americans through community health centers,” Modern Healthcare said.
But the direness of the  situation  and its political heat could ironically lead to the long-term effect of a single-payer system like Medicare being extended to everyone.

Brazil’s community-health approach

June 8, 2015by Robert Whitcomb in Uncategorized tagged , ,

 

brazil

 

This article in The New England Journal of Medicine on Brazil’s family-health strategy may have lessons for U.S. community health efforts, be they of  hospitals, physician groups, Federally Qualified Health Centers or free clinics.

 Interdisciplinary healthcare teams are an important part of the system with each team having a physician, a nurse, a nurse assistant and four to six “full-time community health agents.”
“Each agent is assigned to approximately 150 households in a geographically delineated micro-area within the catchment area — usually the same micro-area where the agent lives. Agents visit each household within their micro-area at least once per month, irrespective of need or demand, and collect individual- and household-level data”

“{T}heworld can learn some lessons from the Brazilian experience. First, community-based primary care can work if done properly. It requires a solid blueprint, pilot testing and evidence generation, a long-term vision, and sustained financial and political commitments. ….Finally, building a robust primary care system is more than a bureaucratic exercise; in Brazil, it has required long-term social movements and professional commitments.”

 

Ruth M. Kelley, FQHC expert, joins CMG

May 21, 2015by Robert Whitcomb in Uncategorized tagged , , , , ,

Ruth M. Kelley  is joining Cambridge Management Group as a senior adviser.

She has decades of leadership in behavioral health. Her management experience and clinical knowledge  from serving Federally Qualified Health Center  (FQHC) clients are of increasing value as the importance and number of FQHC’s swells and as the role of behavioral health becomes better understood by patients, clinicians, payers and policymakers.  She has extensive knowledge of community health centers’ role in integrating primary care and behavioral health.

Ms. Kelley, a seasoned executive  and a registered nurse, has wide experience with a panoply of behavioral-health issues, particularly in serving populations suffering from substance use  and  co-occurring disorders. Her work at The Dimock Center, which runs  a large FQHC in Boston, where she was chief of behavioral health, received national attention.

In 2014, she received The Lifetime Achievement Award from the Association of Behavioral Healthcare,  the largest Massachusetts advocacy organization for mental-health and substance-abuse issues.

She has worked in substance-abuse matters for more than 30 years, during which time she has gained extensive experience in general administration, contract negotiations, grant procurement, program and policy  development for women, men and their families.  She has sat on multiple  professional committees at the local, state and national level.

Before her career at Dimock, Ms. Kelley served as nurse, counselor and coordinator  for patients with substance-use disorders  at the Massachusetts Osteopathic Hospital  and at  New England Memorial Hospital. Before then, she worked at Sancta Maria Hospital, in Cambridge, Mass., where, among other achievements, she designed and implemented a substance-abuse awareness program .

Ruth Kelley has a master’s degree in management from The Heller School of Social Policy at Brandeis University and a bachelor of science degree in nursing from   Northeastern University.

Poor neighborhoods need more or bigger health centers

May 1, 2015by Robert Whitcomb in Uncategorized tagged

 

We at Cambridge Management Group see the vast health problems in an impoverished west Baltimore neighborhood  as showing the need for more and/or bigger health co-operatives and Federally Qualified Health Centers in such distressed places.

 

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