Washington, DC—As part of its ongoing assessment of the impact of Medicaid documentation requirements enacted by Congress in 2006, The George Washington University School of Public Health and Health Services (GW SPHHS) compiled profiles documenting the experiences of community health centers across the country. The details that emerged as part of the research, which is supported by the RCHN Community Health Foundation, illustrate the major and measurable impact the rules are having on access to care and health centers’ operations. Patients, particularly children and citizens, are facing barriers to continued service, and centers are experiencing the financial fallout. Snapshots of the case studies are available at:
- COMMUNITY HEALTH CENTER OF SOUTHEAST KANSAS, PITTSBURG, KANSAS
- HUNTER HEALTH CLINIC, WICHITA, KANSAS
- MARIPOSA COMMUNITY HEALTH CENTER, NOGALES, ARIZONA
The preliminary findings of the study, released in May 2007, revealed the requirements are disrupting coverage for hundreds of thousands of health center patients, while delaying enrollment in Medicaid for potentially hundreds of thousands more. GW SPHHS is now in the process of repeating the survey in order to provide updated results in fall 2007, when House and Senate Conferees are expected to meet to resolve differences in legislation that could ease these requirements.
“Our initial research coupled with these case studies make it clear that the Medicaid documentation requirements are presenting significant enrollment barriers and jeopardizing healthcare access for vulnerable populations,” said study author Peter Shin, PhD, MPH, associate research professor and research director for the Geiger Gibson Program/RCHN Community Health Foundation Research Collaborative.
“The accounts of the community health center leaders underscore the devastating consequences of these requirements,” said Julio Bellber, president of the RCHN Community Health Foundation, which supports ongoing health center research and scholarship at GW SPHHS. “We’ve uncovered these stories and we’re sharing them because we’re dedicated to supporting health centers in their mission to provide exceptional care. If health centers and their patients are compromised because of the new rules, that hurts everyone.”
The research, which includes interviews with community health leaders from Wichita, Kansas; Nogales, Arizona; Pittsburg, Kansas, and others, shows that health centers’ ability to provide care for both their insured and uninsured patients is being adversely affected in the following ways:
- Barriers to Access:
Rather than curtailing enrollment of ineligible individuals, the reforms are affecting American citizens and documented immigrants. The policy has erected particularly daunting barriers to healthcare access for U.S.-born children and, ironically, for American Indians and Alaska Natives, whose tribal documents may not always be officially recognized by the federal government.
- Financial Ramifications:
Because of significant delays in the Medicaid application and enrollment process, health centers suffer adverse financial consequences while they continue to serve patients awaiting coverage determinations.
In 2006, health centers – the largest source of comprehensive primary care for low income patients – served more than 15 million patients, including 5.3 million Medicaid beneficiaries and one quarter of the nation’s children living at or below the poverty level. Medicaid accounts for 37 percent of all health center operating revenues. Results from this initial national impact assessment, the first study to systematically study the effects of documentation rules , show that documentation requirements have caused a nationwide disruption in Medicaid coverage for health center patients.
Sara Rosenbaum, JD, Hirsh Professor and Chair of the School of Public Health and Health Services, and a co-author of the study, commented: “What is staggering is that more than 90 percent of all health centers reported enrollment difficulties for patients of all ages, including newborn children. Our latest data, and the profiles gathered in our interviews, suggest that eligible citizens are experiencing the biggest obstacles to enrollment.”
The initial report, “An Assessment of the Effects of Medicaid Documentation Requirements on Health Centers and Their Patients” can be downloaded here.
The updated results are expected in October.
About the RCHN Community Health Foundation
The RCHN Community Health Foundation (RCHN CHF) is a New York-based not-for-profit operating foundation dedicated to supporting and benefiting community health centers (CHCs) in New York state and nationally. The Foundation develops and supports programmatic and business initiatives related to community health center access, pharmacy and health information technology through strategic investment, research, outreach, education, and coalition building and advocacy. For more information about RCHN CHF, contact Chief Operating Officer Feygele Jacobs at (212) 246-1122, ext. 712, or firstname.lastname@example.org or visit www.rchnfoundation.org.
About The George Washington University Medical Center
The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, DC, metropolitan area for 176 years. The Medical Center comprises the School of Medicine and Health Sciences, the 11th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation’s capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and a subsidiary of Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit www.gwumc.edu.
All news releases available online at www.gwumc.edu/mccm
Sarah Freeman, GW (202) 994-8874
Sara Rosenbaum, GW (202) 530-2343
Peter Shin, GW (202) 530-2313