Community health centers (CHCs) are upgrading their EHR technology and adopting the techniques involved with the patient-centered medical home (PCMH) model in order to meet the new demands of the Affordable Care Act. But a study of CHCs in Los Angeles reveals that just two in five clinics consider themselves ready to handle the influx of newly insured patients while maintaining a high quality of care for the consumers they already serve as the safety net is tested by healthcare reform.
“More people than ever before now depend on community health centers for essential health care,” said Nadereh Pourat, Director of Research at the UCLA Center for Health Policy Research. “CHCs need support to expand beyond their traditional roles and responsibilities if they are going to effectively serve new populations.”
A quarter of clinics are already recognized as PCMHs, the study found, with another 28% in the process of applying and 21% with plans to do so. The 26% that have no plans to apply for the designation may not be doing so out of choice, however. “These organizations may satisfy many of the requirements needed for medical home recognition, but they either lack the resources to commit to the substantial effort required to obtain medical home recognition or have competing priorities,” the report explains.
As indicated by other recent research as well, community health centers are among the most EHR-savvy providers in the nation. Eighty-eight percent of LA clinics are using an EHR, although 41% do not have any providers who participate in the EHR Incentive Programs. A further ten percent hope to implement an EHR within the next twelve months, and the remaining 3% still rely on some electronic tools, like practice management systems and referral systems, even if they don’t have an EHR in place.
Overall, just 40% of CHCs have made enough progress to be ready to handle the 400,000 patients who signed up for health insurance through Covered California, says the LA Times, and the hundreds of thousands who receive coverage through Medi-Cal. About a million people in Los Angeles County alone will remain uninsured, including many undocumented immigrants who often require extra services like translators and may drift between facilities due to unstable housing and working situations. The County plans to assign many of these patients to specific CHCs in the fall of 2014, placing an extra burden on the smallest and least financially stable providers in the system.
The report suggests that CHCs continue their efforts to improve care coordination and a team-based approach to quality care while accelerating the implementation of more robust health IT infrastructures. Community health providers may also wish to collaborate with public and private payers to attract covered patients enrolled through the state’s health insurance exchange in order to maintain financial solvency.