Community health centers in Massachusetts saw a significant increase in their patient load from 2005 to 2007 as the state began implementing its health reform law. In addition, the proportion of the state’s uninsured served at community health centers increased. These findings demonstrate the importance of community health centers and the continuing need for a robust primary care safety net, according to a new report titled, “How is the Primary Care Safety Net Faring in Massachusetts? Community Health Centers in the Midst of Health Reform.”

In April 2006, Massachusetts enacted a landmark, comprehensive health reform law known as “An Act Providing Access to Affordable, Quality, Accountable Health Care,” or “Chapter 58.” The reform sought to achieve near-universal coverage for state residents through individual mandates, expansion of the state Medicaid program and a new subsidized insurance program.

Because community health centers play a particularly important role in Massachusetts, serving one out of every 13 state residents, the impact of reform on that state’s health centers is particularly instructive.

The 34 federally-qualified centers in Massachusetts served 482,503 patients in 2007, up more than 51,000 from two years before, the report found. Further, while there was a decrease in the number of uninsured statewide, the percentage of uninsured Massachusetts residents served by health centers grew from 22 percent in 2006 to 36 percent in 2007, suggesting health centers’ growing importance to Massachusetts’ remaining uninsured population. Meanwhile, health reform did not alter the overall financial status of the health centers. The authors conclude that insurance expansions must be accompanied by investments in health care delivery infrastructure, especially primary care capacity in order to ensure access as well as coverage.

“This study underscores the essential role of primary care in general and health centers in particular as part of comprehensive reform,” said Ms. Sara Rosenbaum, Hirsh professor and chair in the department of health policy at The George Washington University School of Public Health and Health Services.

“The report illustrates the impact of Massachusetts’ health reform on community health centers, as well their continued importance in providing high quality comprehensive care to a broad population,” said Mr. Julio Bellber, president and CEO of the RCHN Community Health Foundation. “The findings provide important considerations for the administration as it plans for health reform nationally.”

The report can be viewed online here.

The research, commissioned by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, was conducted by GW faculty at the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, located in the Department of Health Policy at The George Washington University School of Public Health and Health Services. The Collaborative is a multi-faceted academic training and research initiative created in 2007 through a gift from the RCHN Community Health Foundation.