Affordable Care Act to Fund Improvement of Care for Medicare Patients in 500 Community Health Centers

“Affordable Care Act to help improve care for Medicare beneficiaries

500 federally qualified health centers to receive funding, participate in a program to improve care

Thanks to the Affordable Care Act, 500 community health centers in 44 states across the country will receive approximately $42 million over three years to improve the coordination and quality of care they deliver to people with Medicare and other patients, the U.S. Department of Health and Human Services announced today.

“Health centers are integral parts of our communities,” said Centers for Medicare & Medicaid Services (CMS) Administrator Donald M. Berwick, M.D.  “This initiative will give participating health centers the help they need to improve care for many people with Medicare who rely on them as their main source of care.”

Under this Advanced Primary Care Practice demonstration, created by the Affordable Care Act, Medicare will pay community health centers based on the quality of care they deliver.  This improved payment system will reward clinics for such things as helping patients manage chronic conditions like diabetes or high blood pressure.

In addition, health centers will use this funding to expand their hours, make same day appointments and accommodate patients with urgent care needs.

“The goal of this demonstration is to help patients get the care they need in a primary care setting rather than in an emergency department,” said Dr. Berwick.  “When patients are able to use a health center as their primary source of care, it helps primary care doctors, nurses and specialists coordinate their care.  Health centers will also use health care dollars more wisely as patients receive the right tests, right medications and right treatments in the right setting.”

The demonstration will be conducted from November 1, 2011 through October 31, 2014.  Participating health centers will be paid a monthly fee for each eligible person with Medicare that receives primary care services.  The CMS Center for Medicare and Medicaid Innovation (Innovation Center) and the Health Resources Services Administration (HRSA) will provide technical assistance to help participating community health centers throughout the demonstration.

“The lessons learned from this demonstration project will help all community health centers improve on their long–standing commitment to providing high quality, patient-centered primary care,” said Health Resources and Services Administration (HRSA) Administrator Mary K. Wakefield, PhD., R.N. “This program will help strengthen the relationship between the more than 8,100 health center sites HRSA helps fund and the communities they serve.”

To study the process and challenges involved in transforming community health centers into advanced primary care practices, the Innovation Center will conduct an independent evaluation of the demonstration.  The evaluation will assess the project’s impact on hospital admission rates, emergency department visits rates, access, quality and cost of care provided to Medicare beneficiaries.  The evaluation will also assess whether the demonstration was cost effective.

This Advanced Primary Care Practice demonstration is operated by the Innovation Center in partnership with HRSA.  It is one of a number of initiatives made possible by the Affordable Care Act to help bring better health and better health care not just to Medicare beneficiaries, but to all Americans, while helping use healthcare dollars more wisely.

For example, the HRSA Health Center Quality Improvement and Patient Centered Medical Home Supplemental Funding initiative is providing 904 community health centers nationwide new support to provide care coordination services to patients including care planning and efforts to help doctors work together to deliver better care for patients.

Health centers improve the health of the nation and assure access to quality primary health care services at more than 8,100 service delivery sites around the country.  They are also an integral source of local employment and economic growth in many underserved and low-income communities.  Since the beginning of 2009, health centers across the country have added more than 18,600 new full-time positions in many of the nation’s most economically distressed communities.  In 2010, they employed more than 131,000 staff and new funds, made available by the Affordable Care Act in September, will help create thousands more jobs nationwide.

For more information on how the Affordable Care Act is finding better ways to improve healthcare, visit www.HealthCare.gov.

More information on the Advanced Primary Care Practice demonstration project, including a fact sheet, and a list of participating health centers can be found at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/fqhc/“.