TY - JOUR
T1 - Impacts of the Affordable Care Act on community health centers characteristics of new patients and early changes in delivery of care
AU - Hatch, Brigit
AU - Smith, Ning
AU - McBurnie, Mary Ann
AU - Quach, Thu
AU - Mayer, Kenneth H.
AU - Dunne, Mary J.
AU - Cottrell, Erika
N1 - Funding Information:
This work was supported by the Health Resources and Services Administration, contract no. HHSH250201400001C. The authors greatly appreciate the contributions of all CHARN nodes—Fenway Health, Alliance of Chicago, AAPCHO, and OCHIN, Inc; as well as their academic affiliates—University of Washington, University of California Los Angeles, Northwestern University, and Oregon Health & Science University; and their member CHCs—Chase Brexton Health Care, and Beaufort-Jasper-Hampton Comprehensive Health Services; Erie Family Health Center, Inc, Heartland Health Outreach, Howard Brown Health Center, Near North Community Health Center, North Community Health Center, and PCC Community Wellness; Asian Health Services, Charles B. Wang Community Health
Funding Information:
less likely to forego needed health care (Centers for Disease Control and Prevention, 2015; Garfield & Young, 2015; Sommers et al., 2013, 2014). The effects of the ACA are of particular interest for federally funded community health centers (CHCs), which serve as frontline providers of primary care for medically underserved populations and disproportionately care for patients with Medicaid or no health insurance (Kaiser Family Foundation, 2015). In addition to improved insurance access, the ACA mandated additional direct grant funding to federally qualified health centers via Section 330 grants. These grants are only available to health centers that serve patients regardless of ability to pay and are critical to breaking down barriers to care for the most vulnerable patients. ACA-mandated increase in Section 330 grant funding began in 2011, was continued by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), and continues to be subject to government renewal (Health Resources and Services Administration, 2017). Medicaid expansion under the ACA began in 2014.
Publisher Copyright:
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - The aim of this study was to assess the impact of the Affordable Care Act (ACA) on community health centers (CHCs). Using electronic health records from the Community Health Applied Research Network, we assessed new patient characteristics, office visit volume, and payer distribution among CHC patients before and after ACA implementation, 2011-2014 (n = 442 455). New patients post-ACA were younger, more likely to be female and have chronic health conditions, and utilized more primary care (P < .05 for each). Post-ACA, clinics delivered 19% more office visits and more visits were reimbursed by Medicaid. The support of CHCs is needed to meet increasedThis work was supported by the Health Resources and Services Administration, contract no. HHSH250201400001C. The authors greatly appreciate the contributions of all CHARN nodes—Fenway Health, Alliance of Chicago, AAPCHO, and OCHIN, Inc; as well as their academic affiliates—University of Washington, University of California Los Angeles, Northwestern University, and Oregon Health & Science University; and their member CHCs—Chase Brexton Health Care, and Beaufort-Jasper-Hampton Comprehensive Health Services; Erie Family Health Center, Inc, Heartland Health Outreach, Howard Brown Health Center, Near North Community Health Center, North Community Health Center, and PCC Community Wellness; Asian Health Services, Charles B. Wang Community Health Center, Waianae Coast Comprehensive Health Center, and Waimanalo Health Center; Open Door Community Health Centers, Virginia Garcia Memorial Health Centers, Multnomah County Health Department, and OHSU Family Medicine at Richmond. The authors also appreciate the Data Coordinating Center at the Kaiser Center for Health Research; and in particular, the time and effort spent by analysts—Phil Crawford, MS, and Weiming Hu, MS.
AB - The aim of this study was to assess the impact of the Affordable Care Act (ACA) on community health centers (CHCs). Using electronic health records from the Community Health Applied Research Network, we assessed new patient characteristics, office visit volume, and payer distribution among CHC patients before and after ACA implementation, 2011-2014 (n = 442 455). New patients post-ACA were younger, more likely to be female and have chronic health conditions, and utilized more primary care (P < .05 for each). Post-ACA, clinics delivered 19% more office visits and more visits were reimbursed by Medicaid. The support of CHCs is needed to meet increasedThis work was supported by the Health Resources and Services Administration, contract no. HHSH250201400001C. The authors greatly appreciate the contributions of all CHARN nodes—Fenway Health, Alliance of Chicago, AAPCHO, and OCHIN, Inc; as well as their academic affiliates—University of Washington, University of California Los Angeles, Northwestern University, and Oregon Health & Science University; and their member CHCs—Chase Brexton Health Care, and Beaufort-Jasper-Hampton Comprehensive Health Services; Erie Family Health Center, Inc, Heartland Health Outreach, Howard Brown Health Center, Near North Community Health Center, North Community Health Center, and PCC Community Wellness; Asian Health Services, Charles B. Wang Community Health Center, Waianae Coast Comprehensive Health Center, and Waimanalo Health Center; Open Door Community Health Centers, Virginia Garcia Memorial Health Centers, Multnomah County Health Department, and OHSU Family Medicine at Richmond. The authors also appreciate the Data Coordinating Center at the Kaiser Center for Health Research; and in particular, the time and effort spent by analysts—Phil Crawford, MS, and Weiming Hu, MS.
KW - Affordable Care Act
KW - Community health centers
KW - Health care utilization
KW - Medicaid
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=85056481961&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056481961&partnerID=8YFLogxK
U2 - 10.1097/JAC.0000000000000244
DO - 10.1097/JAC.0000000000000244
M3 - Article
C2 - 29771741
AN - SCOPUS:85056481961
SN - 0148-9917
VL - 41
SP - 250
EP - 261
JO - Journal of Ambulatory Care Management
JF - Journal of Ambulatory Care Management
IS - 4
ER -