The January 1, 2014 implementation of central provisions of the Affordable Care Act (ACA) makes this a time of many transitions for Community Health Center Network and its eight member health centers. The beginning of a New Year is always a good time to reflect on what was accomplished over the past year – and to contemplate the many challenges 2014 offers.
A major achievement of 2013 was our health centers’ pre-enrolling – with support from AHC/CHCN – more than 20,000 individuals in the Medi-Cal expansion. These are individuals who will now have access to a full suite of health care services, including specialty care. Our health centers also are working to enroll individuals who qualify in the Covered California insurance exchange, a process that will continue through the current open enrollment period that ends March 31, 2014.
On the contracting side, the CHCN team has been working on behalf of our health centers to complete contracts for Covered California plans for health center members with incomes over 138% of the federal poverty level. We also successfully concluded negotiations with Alameda County for funding to support our health centers in caring for the approximately 25,000 patients who continue to be eligible for HealthPAC.
Another key development was the AHC/CHCN Board of Directors’ approval of a Strategic Plan for 2013 and 2014. This aggressive plan focuses on several key goals:
- Revenue for the health centers
- Continuing our successful policy and advocacy efforts on behalf of the health centers and the patients we serve
- Supporting our health centers in meeting the “Triple Aim” of better patient experience, better health outcomes, and lower healthcare costs
- Supporting operational improvements at both the health centers and AHC/CHCN.
We are making rapid progress against the Strategic Plan’s goals and objectives – particularly in terms of our historical strengths in managed-care contracting and policy and advocacy. We have translated the Strategic Plan into a set of projects that set the plate for a very busy and productive 2014. These projects include efforts to use data analytics to enable the health centers to improve access to care and their financial health, supporting health centers in the transition to the ICD-10 coding system, and focusing on retaining Medi-Cal coverage for individuals covered through the Medi-Cal expansion. These efforts have the benefit of bringing health centers together for enhanced collaboration and problem-solving.
The coming year will more broadly focus on mapping the future of community health centers as the healthcare landscape continues to evolve in the wake of the ACA. Payment systems are beginning to evolve from the current emphasis on volume of patient visits to proactive population health management and outcomes-based payment. The consolidation of health care also is continuing as large health systems acquire both standalone hospitals and primary-care and specialty-care physician practices. These systems are continuing to raise their prices in a way that challenges funding for other parts of the health care system, including primary care that can prevent emergency room and hospital visits. New information technology offers the potential for both better population management and patient engagement – but also requires considerable ongoing investments. Finally, the health centers’ members are increasingly older patients, many of whom struggle with chronic conditions, and whose needs suggest that a different approach needs to be taken to their care.
In other words, exciting times to work in the safety net. Our biggest strength remains our passionate commitment to advancing the health and well-being of the patients, families, and communities we serve. And these are people and communities who, but for the presence of our health centers, the health care system has not served well. As the New Year begins, the teams at CHCN and AHC are renewing their commitment to supporting our health centers as bulwarks of health and health care for their communities.