Productivity of Federally Qualified Health Centers in the US
Initially, the main aims of FQHC and other community health centers were not only to avail comprehensive care to the patients but also to ensure that the services were of high quality and up to the standards (California Health Care Foundation, 2016). Additionally, it was to make sure that health care was accessible to residents who survived on low income and also respond to the needs of the patients (California Health Care Foundation, 2016). Lastly, these community centers were to ensure that they offered employment, social assistance, and education to the people who reside in these communities.
With the mentioned objectives, exempting the provision of employment, have continued and also expanded to include other services such as the delivery of services regarding mental health, oral health, and other pharmaceutical services (California Health Care Foundation, 2016). Equally important, the number of these community centers has also grown. The growth has been attributed to the fact that the FQHCs have demonstrated their capability by achieving the initial goals and has also helped in cutting the healthcare costs through the reduction of hospitalizations and emergency department services (California Health Care Foundation, 2016). Additionally, the perceived importance of the community health care centers has also supported them by availing financial assistance through trust funds.
It was also established that FQHCs enhances the access to primary care and also leads to improved outcome of the patients. Equally important, it has also been determined that FQHCs have recorded better performance records and at times even better than the non-safety net providers on access to care and measures of quality (California Health Care Foundation, 2016). For example, FQHCs have proved to proved better services in regard o the delivery of preventive services and continuity of care, specifically among the elderly patients and the children (California Health Care Foundation, 2016). FQHCs have also improved access to oral health care and have also been identified to avail adequate care for PTSD. It has also been recognized that an FQHC that embraces the principles of the patients centered medical home, or one becomes advanced primary care practices (APCPs) have further improved the healthcare services as well as health among individuals (California Health Care Foundation, 2016).
Additionally, the fact that FQHC serves a wide variety of patients be it that they are underinsured, uninsured, and other vulnerable patients, has also reduced the disparities associated with access to care (Goldman et al., 2012). For instance, both Hispanic and black patients at FQHC tend to have fewer hospitalizations which are attributed to ambulatory care-sensitive conditions compared to other peers receiving care in other places (Goldman et al., 2012). Likewise, individuals who receive most ambulatory services care in other centers for community health, for instance, the FQHC, have lower medical expenditures in comparison to those who receive care in other places (Goldman et al., 2012). Because of these benefits, most patients prefer using the FQHC even after they have they have obtained medical insurance.
The FQHCs have also been identified to be effective since they are meeting their initial goals through serving populations with low incomes with cost efficient and quality healthcare. Specifically;
Community health care centers, such as the FQHC and other like have registered high records in the manner they are providing health care (Health Resources and Service Administration, 2016). For example, it has availed care to more than 20 million individuals in the entire United States of America and more than half a million people in the state of Michigan. In the year 2010, more than 15 percent of patients who were uninsured were served in these centers. Equally important, with the expanding ACA Medicaid, FQHCs have been projected to become increasing more significant in the entire healthcare system (Health Resources and Service Administration, 2016). A study conducted in healthcare located in Massachusetts indicated a positive impression regarding the FQHCs because even after people were insured, most of them did not shift to private healthcare centers. In fact, the studies indicated that the health care centers registered an increase in the percentage of the volume of patients who visited these institutions between the years 2005 and 2009 (Health Resources and Service Administration, 2016). FQHC and other like healthcare centers engaged in availing care for people who had newly acquired medical insurances, particularly during a time when many of them had a rough time in seeking primary care. Additionally, these centers also availed to help in enrolling the newly eligible patients in obtaining their insurance (Health Resources and Service Administration, 2016). As an indicator that the HQFC and other centers are effective, the National Association of Community Health Centers has projected their growth whereby they are expected to have a double capacity of up to more than 40 million patent by the year 2019 (Health Resources and Service Administration, 2016). At a state level, the Michigan Primary Care Association that their health centers should have increased the patient capacity from around half a million to one million patients by the year 2018.
It has also been noted that the productivity of HQFCs has improved to the extent that the quality of healthcare services are comparable to those offered in private healthcare centers, and this is despite the fact that they serve patients who are sicker and have no stable incomes (Health Resources and Service Administration, 2016). Research has also indicated that though there is some variability across healthcare institutions, the HQFC programs have at times performed in a similar manner as the private sectors (Health Resources and Service Administration, 2016). On other occasions, the programs have performed better regarding ambulatory care, management of chronic diseases, appropriate prescription of elderly patients, and administration of preventive counseling (Health Resources and Service Administration, 2016).
HQFCs have also maintained their productivity by being cost effective. These centers have demonstrated lower rates of hospitalizations that are preventable, and low emergency visits compared to populations that did not use the health centers, and this is attributed to the fact that these centers focus on primary care and also avail a regular source of care (Hennessy, 2013). A study conducted in the state of Michigan indicated that FQHC enabled the Michigan Medicaid program to save up to $ 44.87 per every patient in a period of one month (Hennessy, 2013).
On overall, the health care centers such as the HQFC have achieved most of their legislative goals but at the same time facing challenges. Some of the problems include shortage of clinical staff, long-term sustainability, lack or no collaboration with other health care providers, and denial of accessing specialty care (Hennessy, 2013). Additionally, provision of adequate funds to these centers has been a challenge. Also, many people are obtaining coverage, and therefore the clinical centers are expecting shortages of clinical staff including nurses, primary care physicians, mental health professionals, and dentists (Hennessy, 2013). These centers have also continued to experience difficulties that have prevented them from acquiring specialty referrals because most of the refuse on the ground that they cannot attend to patients on Medicaid as well as those who are uninsured (Hennessy, 2013). Lastly, the HQFCs find it difficult in coordinating with other health care institutions and other service providers.
Both the policy makers and the general public will have more expectations than the general comparisons and rankings indicated in the report. In the research findings, disparities associated with access to health care have been well documented, and as shown, many organizations have shown concern. Specifically, the attentions these differences have had have extended to the national platform where the government, researchers, and other healthcare organizations have attempted to address the concern.
With the findings in mind, the public and other organizations in mind will be in a position to come up with strategies aimed at addressing the disparities. Particularly, the public will have greater input because the Medicaid program affects them. That is, most citizens are not eligible for the program. Additionally, individual managing these programs have also turned out to be a barrier and dentist are not able to participate in the provision of these services.
The findings will be of use to both the public and private healthcare centers. To start with, challenges facing the HQFC centers have been identified, and this may be used as a manual or a guideline that will lead to incorporation of programs aimed at addressing the issues. For instance, it was found out that most private physicians do not avail themselves in treating patients who are not insured or either under the Medicaid program. At the same time, the results indicate that the HQFC programs have at times beaten the private sector in the delivery of healthcare services. Such a finding can be used by these organizations in identifying a common ground with the purpose of solving the challenge.
Limitations of the Research
Although the study was successfully carried out, there cannot lack some constraints and shortcomings that were unavoidable. First, because of the time availed, the research data was mainly obtained from secondary sources. Therefore, a lot of generalization has been made because there are no personal confessions from people who have experienced the nature of services availed by the HQFC centers. Additionally, the language barrier was a limitation. The research was limited to English speakers, which could have limited potential date from being retrieved from other people who did not speak English.
The measure used in the collection of data is also a shortcoming. For example, on completion of interpreting the findings, it was noted that the inclusion of non-English respondents would have made a difference. It is estimated that in research, every opinion counts and failure to include such respondents means that the study has failed to cover every aspect comprehensively.
Longitudinal effects also contributed to the limitations of the research finding. These effects occur because students, unlike other researchers who devote an entire eternity in research of a single topic, students do not have all the time to observe stability or change because of time constraints. Therefore, the issue addressed, in this case, was selected by the fact the available time would be enough for the completion of the study
The research mainly focused on the productivity associated with HQFC centers. In general, the study should have focused on addressing the entire healthcare system as well as the influence of the APA act on these healthcare centers. Additionally, the literature has not addressed whether private physicians fail to help Medicaid and uninsured patients based on the regulations imposed on them or they do so at their will.
Summary and Conclusion
In conclusion, the principal intent of this paper was to determine the productivity of Federally Qualified Health Centers (FQHCs) in the United States which has been a success. The general conclusion is that FQHCs enhances the access to primary care and also leads to improved outcome of the patients. Equally important, it has also been determined that FQHCs have recorded better performance records and at times even better than the non-safety net providers on access to care and measures of quality. For example, FQHCs have proved to proved better services in regard o the delivery of preventive services and continuity of care, specifically among the elderly patients and the children.
It has also been noted that the productivity of HQFCs has improved to the extent that the quality of healthcare services are comparable to those offered in private healthcare centers, and this is despite the fact that they serve patients who are sicker and have no stable incomes. Research has also indicated that though there is some variability across healthcare institutions, the HQFC programs have at times performed in a similar manner as the private sectors. On other occasions, the programs have performed better regarding ambulatory care, management of chronic diseases, appropriate prescription of elderly patients, and administration of preventive counseling.
In future, a broad and issue such as the productivity associated with the HQFC should be allocated more time to select the most convenient and reliable data collection methods. Also, the research should not have language limitations as they are a barrier to accessing data, it is therefore recommended that the people conducting research should be accompanied with translators.
California Health Care Foundation. (2016). Stepping Up to the Plate: Federally Qualified Health Centers Address Growing Demand for Care. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20S/PDF%20SteppingUpPlateFQHCs.pdf
Goldman, L. E., Chu, P. W., Tran, H., Romano, M. J., & Stafford, R. S. (2012). Federally qualified health centers and private practice performance on ambulatory care measures. American journal of preventive medicine, 43(2), 142-149.
Health Resources and Service Administration. (2016). Goal 1: Improve Access to Quality Health Care and Services. Retrieved from https://www.hrsa.gov/about/strategicplan/goal1.html
Hennessy, J. (2013). FQHCs and health reform: up to the task. Nw. JL & Soc. Pol’y, 9, i.