A new research brief from The George Washington University Department of Health Policy, supported by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, examines the potential effects of national health reform on the nation’s 96.2 million residents of urban and rural medically underserved communities. Using government data, the research brief estimates that 72 percent of medically underserved community residents are insured; yet residents of these communities experience ongoing barriers to adequate health care, as measured by population health and social risk, a shortage of primary health care or both.

The brief identifies key investments and safeguards that can help assure that critically important insurance expansions into a lower income, at-risk population actually translates into improved health care quality, the reduction of disparities in health and health care, and greater system efficiencies.

The Brief, “National Health Reform: How Will Medically Underserved Communities Fare?” examines the factors underlying medical underservice. It finds that the number of Americans living in communities at risk for medical underservice is more than double the number of persons who are uninsured nationally. The report notes that even with health insurance reform, these communities and providers that serve them will continue to be affected by elevated numbers of low income uninsured persons, as well as persons who may be seriously under-insured because of poorer health status and lower family income.

Describing health insurance expansion as the single most important strategy to alleviate medical underservice, the Brief also identifies a series of safeguards and investments essential to long term quality and efficiency improvements in underserved communities, which disproportionately bear the burden of infant mortality, as well as chronic illness among children and adults from conditions such as childhood and adult asthma, diabetes, cardiovascular disease, and behavioral disorders.

Key safeguards and investments encompass:

1. Expanded Medicaid for both low income children and adults because of the program’s comprehensive coverage and strong cost sharing protections;

2. Key health care access and patient protections in all health insurance products sold in medically underserved communities in order to prevent the under-service of plan members underpayment health care providers that continue to treat the uninsured and under-insured;

3. Direct investments in programs such as community health centers and the National Health Service Corps;

4. Investments aimed at fostering clinical integration and partnerships among health care providers serving medically underserved communities; and

5. Public health investments.

“National health reform must address both coverage and access,” said Mr. Julio Bellber, president and CEO of the RCHN Community Health Foundation. “Investment in primary care is essential to ensure that there is sufficient capacity to meet community need.”

“The success of national health reform for medically underserved communities ultimately will be measured not only in terms of the number of residents who gain insurance coverage but also by how well insurance reforms translate into health care access for community residents,” said Ms. Sara Rosenbaum, a study co-author and chair of the department of health policy.

“National Health Reform: How Will Medically Underserved Communities Fare?” can be viewed online here.