Connecticut’s Community Health Centers are the medical, dental, and behavioral health home to over 440,000 people and play a critical role in the state’s health care strategy. As a safety net provider, nearly 60% of our patients are covered by the state’s HUSKY (Medicaid) program. While acting as the patient’s medical home, these centers keep patients from developing more serious conditions with higher costs.
A study published by the Connecticut Department of Social Services (DSS) in early January found the state of Connecticut is failing to adequately fund these facilities and the under-funding is putting patients at risk.
DSS’s survey of peer states found that Connecticut falls dramatically short when it comes to reimbursing Community Health Centers for the care they provide patients under the Medicaid program. The study shows that Connecticut’s payment rates are, on average, 20% lower than the comparison states chosen. A more extensive analysis of payment rates across the country by the Community Health Center Association of Connecticut shows our state’s rates are the lowest in New England, the lowest in the entire Northeast – and in the bottom third of the United States, all while Connecticut is a top-five most expensive cost of living state.
When it comes to public health and public policy, this is clearly a pound-foolish approach.
As we look toward the start of this year’s legislative session, some lawmakers see the flawed logic and are planning to introduce budget proposals to correct this festering problem. Just like other providers of care, this reimbursement issue has persisted for over a decade. Simply put, Connecticut’s Community Health Centers can no longer subsidize the state’s Medicaid program.
Although Community Health Centers are non-profit institutions, they are managed like any other business. When health centers are underfunded by a state’s Medicaid program, the management decisions that must be made to balance budgets will be familiar to anyone who has ever run a business. When revenues fall short, staff and services must be reduced or even eliminated.
But unlike other businesses, when Community Health Centers reduce expenses, or close, the result affects the health and well-being of thousands of Connecticut residents. Cuts also lead to longer wait times for families seeking care and more expensive care options, and more complex problems develop over time.
Community Health Centers are required by law to accept all people, regardless of ability to pay – including any patient enrolled in HUSKY. They cannot turn away HUSKY patients like other practices can. People need care, and, for nearly half a million Connecticut residents, they rely on Connecticut’s Community Health Centers.
Policymakers are correct to question how healthcare dollars are being spent as they consider the entire state budget. Community Health Centers are not a state budget buster. In fact, a variety of studies have demonstrated that Community Health Centers can bend a state’s health care cost curve. If funded properly, health centers can help reduce some of the largest healthcare line items in the state budget including pharmacy, emergency room utilization, and hospitalizations.
But the continuation of a policy that deliberately squeezes Community Health Centers to create the illusion of savings ends up costing our patients access to quality health care and the state more dollars in the long run.
Gov. Ned Lamont’s budget proposal – which will be unveiled in February – can set the table for the discussion over proper funding. Since a report from his own DSS points to the emergency need for increased funding, we are hopeful the governor will make Connecticut community health a top spending priority.
We understand there are competing interests when it comes to state spending, but few are more important than public health, and few up-front investments are certain to produce more positive outcomes both in terms of the health of Connecticut residents and the long-term health of the state budget.
We urge state government leaders to use this year’s budget to correct this chronic issue as a matter of public health.
Shawn K. Frick is the CEO of the Community Health Center Association of Connecticut which represents sixteen Community Health Centers throughout Connecticut.