What Can Independent Providers Learn from Health Centers?

In honor of National Health Center Awareness Week (#NHCW18), we’re highlighting the essential role these organizations play. Health centers often counteract the decline of the primary care physician, especially in rural areas. However, given these centers’ emphasis on the social determinants of health, health centers provide insight for any primary care physician looking to improve their practice.
First, it’s necessary to define a health center. Health centers are community-based and patient-directed organizations that aim to deliver comprehensive, culturally competent, high-quality primary healthcare. Health centers also often integrate access to pharmacy, mental health, substance use disorder, and oral health services in areas where economic, geographic, or cultural barriers limit access to affordable health care services. These sites receive $5.1 billion in federal funding to provide free or low-cost care to 27 million patients each year. Last year alone, health centers generated $45.6 billion, while saving the healthcare system $24 billion while helping improve patient outcomes.
These organizations are structured around reducing unnecessary hospitalizations, maintaining patient engagement and satisfaction levels, lowering costs of healthcare, and improving access. The results are impressive. One study found that the cost of Medicaid enrollees who are health center patients was 24 percent lower than non-health center patients and accounted for 25 percent fewer inpatient admissions. Another study shows 67 percent of health center patients have their diabetes controlled, exceeding the national average of 57 percent, and 63 percent of hypertensive patients have their blood pressure controlled, exceeding the national average of 57 percent.
How can health centers accomplish these goals? Through initiatives built around social determinants of health.

Social Determinants of Health

The National Association of Community Health Centers (NACHC) states that life expectancy and health status is determined largely by social and economic factors account (40 percent), health behaviors (30 percent), and physical environment (10 percent), leaving only 20 percent to clinical care.
Health centers score high on accounting for social determinants of health according to a study from the Journal of the American Board of Family Medicine. Surveyed health centers implemented screening processes that involved 13 common social determinants of health — demographics, living arrangements, cultural and functional status — to “ensure proper monitoring of feedback” needed to “monitor social determinants of health across a national population of differing communities, values, and resources,” researchers said.
In addition to providing care for the most vulnerable populations, they also offer non-clinical services such as health education and translation to ensure patients can access care and understand the treatment they’re prescribed. As we’ve demonstrated, this attention to health literacy is a strong predictor of positive health outcomes.
Health centers also partner with community groups to counsel patients on employment opportunities, housing assistance, transportation, and food banks. NACHC researchers found that the “majority of physicians [85 percent] reported that unmet needs are directly leading to worse health, and yet they concede they lack confidence in their capacity to address their patients’ needs.” Fostering partnerships is one way to ensure patients’ needs are met outside the office.
Health centers operate efficiently because they account for the difficulties in patients’ lives that discourage them from entering the office, building the patient-doctor relationship, and collaboratively embarking on a treatment plan. If you want to learn more about how to ensure patients take that crucial first step of visiting your office, read our free whitepaper on how to reduce patient no-shows.