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Access to 'health care home' other half of reform equation

May 27, 2007

April 26, 2007
By Frances M. Anthes and Zoila Torres Feldman
(c) Telegram & Gazette

This week, Great Brook Valley Health Center and Family Health Center of Worcester and other organizations across the United States will take part in the national Cover the Uninsured Week. Thousands of events and activities will be held across the country to raise awareness of the millions of Americans living without health insurance, many of whom have had little or no contact with a doctor's office their entire adult lives. But that reality is beginning to change for many of Massachusett's uninsured residents - estimated at 372,000 last summer - as the state works to implement its historic health care law. One year after the law's passage, 110,000 previously uninsured Massachusetts' residents now have health coverage - a remarkable achievement by any measure.

However, there is more to this emerging success story. As the state's 52 community health centers continue to enroll residents into Massachusetts' new low-cost health plans, they are offering the newly insured something equally critical: a health care home - a place where they can access a team of caregivers, including specialists, who come to know them and their health care needs.

Establishing a health care home is the first step in accessing effective, comprehensive health care. According to a recent study on the importance of health care access by the National Association of Community Health Centers and the Robert Graham Center, people who receive routine medical care are better able to prevent sickness, manage chronic illnesses such as diabetes and asthma and avert emergency room visits and hospital stays than are people without a regular source of primary care - a health care home.

In 1965, the nation's first community health center opened its doors in Boston. Until that time, health services for the low and moderate-income people in inner city areas and isolated rural communities where nowhere to be found. Today the community health center network represents the largest unified primary health care program in the United States. In Massachusetts, 185 practice sites serve more than 700,000 Massachusetts residents yearly.

Community health centers like Family Health Center of Worcester and Great Brook Valley Health Center excel at providing comprehensive primary and preventative care and chronic disease management in accessible, lower-cost community settings. Staffed by caregivers who speak the languages and understand the cultures of their communities, health center effectiveness is reflected in improved health outcomes for patients, including a significant reduction in infant mortality and low-birth-weight babies, and an increase in patient self management of chronic diseases such as diabetes. At both Family Health Center and Great Brook Valley Health Center, a culturally compentent, multidisciplinary approach to prenatal care has resulted in fewer low birth weight babies. In 2005, Great Brook and Family Health each had a low birth weight baby rate of 3.7 percent compared to 8.3 percent for Worcester as a whole.

This success is a reflection of the quality health care centers provide. Health center patients receive their care from board-certified physicians trained at some of the country's best medical schools. And, like Massachusetts hospitals, our health centers undergo rigorous on-site accredidation visits and regularly meet national quality and performance standards.

Such quality, comprehensive care has an added bonus for all Massachusetts residents: Effective health care generates savings for the state's entire health care system. By keeping patients healthier and treating patients who would otherwise seek care through costly hospital emergency room visits or end up in hospital beds because of delayed treatment, overall savings are passed on to the state's Medicaid program and other insurers.

As organizations across the United States mark Cover the Uninsured Week, many eyes will turn to Massachusetts and its unprecedented effort to make health care affordable and accessible for virtually all of its residents. The role of community health centers will be critical to the success of that endeavor. Providing health insurance coverage is half the equation, the other half is encouraging individuals to access care that will help them live healthier lives.

Massachusetts health centers work to mirror the communities they serve - with staff that speak the languages and understand the cultures of their patients. This may be their greatest strength, allowing for the creation of a welcome, comfortable and comforting space for quality, comprehensive patient care - a health care home.