The Vital Role of Community Health Centers: Q&A With the National Association of Community Health Centers

Modern Medicaid Alliance (MMA): How vital is the role of Community Health Centers in improving health outcomes and reducing barriers to care for Medicaid beneficiaries and other patients?

Jeremy Crandall (National Association of Community Health Centers): Health centers are a critical lifeline for underserved patients, and they pride themselves on delivering high-quality, effective, all-encompassing, affordable primary care to all Americans, regardless of their ability to pay. In the face of dire workforce shortages, health centers have received bipartisan recognition and support for their role in testing and vaccinating low-income Americans. Health centers serve as the health home for more than 30 million people, including 1 in 6 Medicaid beneficiaries and 1 in 3 people living in poverty.

Health centers are often the only option for patients who disproportionally suffer from chronic conditions and health disparities. Health centers set themselves apart because they provide access to critical primary care and wrap-around care to address the social drivers of health – housing and food insecurity, case management and health literacy, among many others. Importantly, health centers also drive better value in care delivery, saving the health care system $24 billion per year and $2,300 per Medicaid patient.

MMA: Generally speaking, what is Medicaid’s role as it relates to Community Health Centers? 

National Association of Community Health Centers: Community Health Centers and Medicaid share a proud and enduring partnership since they sprang into existence in 1965. Their shared relationship and sense of mission have been essential for health system transformation. Every other patient that walks through the doors of a health center is on Medicaid. Nine in ten are at or below 200% of the federal poverty level. Health centers care for a large population of Medicaid beneficiaries for a fraction of the cost – less than 2% of total Medicaid spending.

Given the nature of community health centers and the patients they serve, it cannot be underscored enough why a strong Medicaid program that protects enrollees, especially in a tough economy, is critical for community health centers to be able to serve their patients effectively.

MMA: How has COVID-19 impacted the landscape for Community Health Centers? In what ways has their role grown throughout the pandemic? 

National Association of Community Health Centers: Community health centers have been critical partners in the national response to COVID-19. In the early days of the pandemic, one health center doctor described the experience as “practicing medicine as if at war.” In a matter of months, health centers pivoted and changed the way they delivered care – changing workflows, creating pop-up testing and vaccination sites around the country, and expanding telehealth options.

The ability of health centers to provide telehealth care has been a lifeline for patients to continue receiving care during the pandemic. In 2020, 95% of health centers nationwide offered telehealth services compared to just 43% in 2019, most notably because of various Medicare flexibilities put in place by the Department of Health and Human Services and Congress. 92% of health centers also reported that audio-only telehealth flexibilities improved patient access to care.

Care teams at health centers have been critical to enhancing COVID-19 vaccine awareness and administration. Health centers have administered 22.2 million COVID-19 vaccines to underserved patients across the country. Health centers have also been a primary point of contact for patients regarding their enrollment and continuous Medicaid coverage throughout the Public Health Emergency (PHE). Further, health centers will play a critical role as states prepare for the end of the PHE and must inform Medicaid and CHIP beneficiaries of their insurance coverage options.

MMA: Can you tell us a little more about National Health Center Week (NHCW) and your activities this year, especially related to people enrolled in Medicaid?

National Association of Community Health Centers: There are hundreds of activities from coast to coast celebrating NHCW, with focus days dedicated to different aspects of the health center community — patient appreciation day, stakeholder appreciation day, health care for the homeless, agricultural worker appreciation day, and public housing. We’re also grateful that the White House marked the national celebration of NHCW by issuing a Presidential Proclamation.

MMA: What are your current top advocacy priorities, specifically priorities relating to Medicaid?

National Association of Community Health Centers: Key upcoming Medicaid priorities include supporting health centers and Medicaid enrollees as states prepare for the end of the PHE and must inform Medicaid and CHIP beneficiaries of their insurance coverage options, continuing the expansion of telehealth flexibilities, advancing coverage options to improve health equity, and rebuilding the primary care workforce. We also remain focused on securing the resources and support needed to continue to respond to COVID-19 and care for patients with long-COVID.

Jeremy Crandall is the Director of Federal and State Policy at the National Association of Community Health Centers.