Community Health Centers Under Pressure to Improve Care

by | May 1, 2012

From: Kaiser Health News / USA Today

Hundreds of the nation’s nearly 1,200 federally funded community health centers fall short on key quality of care measures, according to federal data analyzed by Kaiser Health News and USA Today. The centers’ performance most often lagged national averages on helping diabetics keep their blood sugar under control and screening women for cervical cancer.

After doubling the number of patients served in the past decade to more than 20 million people a year, the mostly privately run, nonprofit centers are coming under increased pressure as they gear up for a major expansion under the health care law. Beginning in 2014, about 30 million Americans are expected to gain health coverage, half through Medicaid, the state-federal insurance program for the poor. Congress authorized $10 billion to expand the centers’ capacity on the assumption many of the newly covered would seek care there.

Since 2008, they have also been required to report data to the federal government on six performance measures, including how well they care for their patients with diabetes and high blood pressure, screening rates for cervical cancer, vaccination rates for children, provision of timely prenatal care and rates of low birth-weight babies.

A KHN-USA Today analysis of the 2010 health center data, obtained through the U.S. Freedom of Information Act, shows the level of care varies widely, including by region: Centers in the South generally perform worse than those in New England, the Midwest and California.

The analysis also found that:

— Nearly 75 percent of centers performed significantly worse — at least 10 percent below the national average for the entire U.S. population — for cervical cancer screening rates. While 75 percent of U.S. women had at least one Pap test for cervical cancer in the past three years, the average was 58 percent for women in community health centers, according to federal data.

–About 73 percent performed significantly below average in helping diabetics maintain their blood sugar levels.

— About 28 percent of centers performed significantly below average for immunizing 2-year-olds.

— Georgia was the only state to rank near the bottom on four of the six quality measures.

— Four other states — Louisiana, Virginia, Kansas and Kentucky — ranked near the bottom for three measures.

Federal officials point out that patients at the nation’s community health centers sometimes get better care.

For example, three out of four centers performed significantly better than the national average in helping hypertensive patients keep their blood pressure under control and more than four in 10 do significantly better at making sure women get timely prenatal care.

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