Monday, December 16, 2013

A Geographic Look at Health Insurance


Federal health reform has spawned its share of data analysis, but a new interactive infographic from the consumer finance Web site ValuePenguin allows a community-level view. It enables you to look at your own county and see the percentage of the population who are uninsured, costs of coverage under the Affordable Care Act, and how many companies are offering plans on the exchange. Data for the tool come from the Census, HealthCare.gov and state insurance exchanges.

Monday, November 25, 2013

Register Now for Capital Link's Upcoming Webinars on 12/4 & 12/11!


Capital Link is continuing our series of webinars for Health Centers and Primary Care Associations!  Our webinars have no charge, but participation is limited to the first 100 registrants. Register today! Contact Crystal Chappell at cchappell@caplink.org or 617-988-2214 with any questions.

Creating Optimal Environments for Primary Care Teams
Wednesday, December 4th, 2-3 p.m. EST

Presenter: Cindy Barr, Operations & Facilities Planner, Capital Link

Click here to register for 12/4 webinar! 

Growth Planning: Tools and Techniques to Win the Growth Race
Wednesday, December 11th, 2-3 p.m. EST
Presenter: Terry Glasscock, Senior Project Consultant, Capital Link
Click here to register for 12/11 webinar! 

Complete descriptions of our webinars are on our website here. We hope you will join us!

Wednesday, November 6, 2013

New Resource on the National Financial and Operational Trends of Health Centers


Capital Link and Community Health Center Capital Fund (Capital Fund) announce the release of Community Health Center Financial Perspectives, Financial and Operational Ratios and Trends, 2008-2011: A Guide for Community Health Centers, the first in a series of field-building resources sponsored by the Citi Foundation.  This analysis was completed to provide insight into multi-year financial trends for health centers on a national basis, critically important at a time when Federally Qualified Health Centers are expected to grow from serving over 22 million patients currently to 40 million patients over the next several years. In order to effectively manage this growth, health centers need to be able to benchmark their financial and operational performance to peer organizations. Without easily available comparative data, it has been difficult for health center leaders to identify and adopt best practices—an essential activity as health centers seek to thrive in the highly-competitive health care world.

Key findings are illustrated in our infographic. The complete resource document containing detailed financial and operational data is available at www.caplink.org/resources/reports.

http://www.caplink.org/images/stories/Citi_Infographic_9_9_13.pdf

Wednesday, October 23, 2013

Health Centers National Capital Needs Survey: Extended to Nov 12


Periodically Capital Link conducts a national capital needs assessment, with support from HRSA, to determine the extent of existing and future health center capital requirements. This study provides an estimate of the need for additional capital investment so health centers and Primary Care Associations can plan for growth. The data also helps us identify strategies for securing capital funding for health centers.

Health center participation is critical to the process of developing effective capital development strategies for centers nationally.  On October 16th, an electronic questionnaire was sent to health center CEOs and Executive Directors on Capital Link’s mailing list. If your health center did not receive this questionnaire, please contact Steve Rubman, Manager of Data Resources & Analysis, at srubman@caplink.org. We thank you for your assistance. Responses are due November 12th.  

Tuesday, October 15, 2013

"Lenders Coalition for Community Health Centers" Launched


Seventeen Community Development Financial Institutions (CDFIs) that finance community health initiatives have established the Lenders Coalition for Community Health Centers (LCCHC) to press for policies that will strengthen health centers' access to capital and CDFIs' ability to finance community health center growth. The LCCHC was launched on October 15 at the annual Opportunity Finance Network conference in Philadelphia.

 
"CDFIs play a critical role in helping community health centers obtain affordable capital to strengthen their capacity and expand their facilities. But CDFIs need greater resources and policies to finance rapid growth of community health centers," said Allison Coleman, Chair of the LCCHC Steering Committee and CEO of Capital Link. "The LCCHC will educate policymakers about issues that impact health center growth, financial stability and access to capital, and advocate for policies and resources that enhance CDFIs' ability to foster community health center expansion."

 
For the complete press release, visit http://lcchc.wordpress.com/news/

Tuesday, October 8, 2013

Market Assessment Data Sources While the Government Is Shut Down

By Rebecca Polan, Capital Link Project Consultant and Market Assessment Specialist

Just because the Census website is shutdown doesn’t mean that your market assessment efforts need to be too!  Below is a list of alternate data sources that health centers can use for market research efforts.

·    HealthLandscape (www.healthlandscape.org):  In addition to a terrific visual interface, try the Community HealthView (under “Tools”) in order to access US Census data from the American Community Survey as recent as 2009, all the way down to the census tract level.  Health Landscape includes demographic data, health outcome data, HPSAs, health facility locations and more.   Just select your map, and click the data export tab on the top left and the data is yours!

·     UDS Mapper (www.udsmapper.org):  The UDS Mapper offers basic income, poverty and ethnicity data at the zip code level, also from the Census American Community Survey (ACS) database, for 2011.  In addition, get aggregate FQHC patient data for 2012, also at the zip code level.  The UDS Mapper was brought to us by the creators of HealthLandscape, so the interface, including the data download options, is very similar.

·    Upset that the Census’ Small Area Health Insurance Estimates are not available?  This "Mapgirl" is.  Try the following sources for data on the uninsured:

o   PolicyMap (http://www.policymap.com/maps):  While you can’t access the data behind the maps, you will see very detailed visual data on the uninsured population for 2010 in your county by age as well as by income (including at or below 200% of poverty).  In addition PolicyMap has a wealth of other maps available for free that provide a bird’s eye view understanding of neighborhood conditions, demographics, economic indicators and more.

o   Community Health Status Indicators (http://wwwn.cdc.gov/CommunityHealth/homepage.aspx?j=1):  CHSI is one of the few Center for Disease and Control sites that is still open.  Find your county, click on Access to Care and find the exact number of uninsured individuals in your county for 2009.

o   State databases for Behavioral Risk Factor Surveillance System (BRFSS) data:  BRFSS data is available in most states down to at least the county level via state databases.  A quick web search will allow you to access a wealth of data regarding health insurance status, access to care, as well as a number of behavioral data points related to drinking, smoking, exercise, etc.

For more data options, see http://mashable.com/2013/10/02/government-shutdown-websites/. If you have any questions as you explore these resources, feel free to contact Rebecca Polan, (also known as Mapgirl) at rpolan@caplink.org.
 

50-State Medicaid Budget Survey Highlights Trends for FY13 and F14


The Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA) recently conducted the 13th annual budget survey of Medicaid officials in all 50 states and the District of Columbia. The report highlights trends in Medicaid spending, enrollment and policy initiatives for FY 2013 and FY 2014 with an intense focus on eligibility and enrollment changes tied to the implementation of the Affordable Care Act as well as payment and delivery system changes. The report also provides detailed appendices with state-by-state information and a more in-depth look at four case study states:  Arizona, Florida, Kentucky and Washington. Download the report and an executive summary here.

According to Kaiser’s release, key findings from the survey include the following:

  • Improvements in the economy resulted in modest growth in Medicaid spending and enrollment in FY 2013.  In FY 2014, national enrollment and spending growth are expected to rise.  States moving forward with the Medicaid expansion are expected to see higher enrollment and total spending growth driven by increases in coverage and federal funds.
  • The implementation of the ACA will result in major changes to Medicaid eligibility and enrollment for all states whether they are implementing the ACA Medicaid expansion or not.
  • Nearly all states are developing and implementing payment and delivery system reforms designed to improve quality, manage costs and better balance the delivery of long-term services and supports across institutional and community-based settings.
  • Improvements in the economy have enabled states to implement more program restorations or improvements in provider rates and benefits compared to restrictions, but states also adopted policies to control costs and enhance program integrity.
  • Looking ahead, FY 2014 will be a transformative year for Medicaid.

Thursday, September 19, 2013

Health Insurance Marketplace Resource Roundup


We’re getting down to the wire: in less than two weeks the Health Insurance Marketplaces open, and enrollment will open in October for health coverage that begins January 1, 2014.  Earlier this week, President Obama and Health and Human Services Secretary Kathleen Sebelius held a phone call for all community organizations that are focused on outreach and enrollment, including health centers.  On that call, Secretary Sebelius said that we are “on the edge of history,” approaching the “moment that provided health security to millions of Americans.” 
 
Below are some key links for the final push to help educate the uninsured on their options for gaining insurance:
 
Enroll America is an organization created to “maximize the number of uninsured Americans who enroll in health coverage made available by the Affordable Care Act.”  Its website is a well-organized clearinghouse of current information for those focused on outreach and enrollment, and includes tips for outreach planning, talking with patients about their options, and up-to-date information in webinar, report and blog form: http://www.enrollamerica.org/ 

 Consumer information about the Health Insurance Marketplace is available here: https://www.healthcare.gov/

Employer and provider information about the health insurance marketplaces, navigator training, and many factsheets for providers, employers and small businesses is available at this link: http://marketplace.cms.gov/    
 
Navigator training requirements for state and federal Marketplaces available from HRSA here:  http://www.bphc.hrsa.gov/outreachandenrollment/
 
The National Association of Community Health Centers (NACHC) has many other helpful links related to outreach and enrollment here: http://www.nachc.com/Info%20on%20Outreach%20and%20Enrollment.cfm

At NACHC’s August Community Health Institute, Jim Macrae, Associate Administrator for Primary Health Care, Health Resources and Services Administration,  suggested that health centers consider hiring veterans as their outreach and enrollment staff.  As of September 2013 there are an estimated 22 million veterans across the country.  Data on the veteran population by county as well as by congressional district is available at the Department of Veteran Affairs website: http://www.va.gov/vetdata/veteran_population.asp. To conduct outreach to veterans start with Veterans Service Organizations, a directory of which is at this link: http://www.va.gov/vso/.

Tuesday, September 10, 2013

New Report Examines the Organizational Factors Impacting the Financial Performance of California Clinics



Capital Link announces the release of a comprehensive report sponsored by Blue Shield of California Foundation and the California HealthCare Foundation. The study was conducted to better understand the financial health of the California clinic safety net and factors that may positively influence the development of high performing health clinics. The research also developed a framework for grouping clinics by similar operational characteristics to enable benchmarking and sharing of best practices.

Community clinics, which serve California’s underserved, have been consistently growing in terms of patient utilization, revenue, and number of sites operated per clinic. Many clinics continue to struggle financially despite the growth. The report, which provides a profile of clinics’ financial health between 2008 and 2011, concluded that several factors were important determinants of a clinic's financial and operational performance.

Click here for our infographic, which contains selected highlights of the study.

Click here to download the complete report from Capital Link's website.

Click here to download an issue brief from Blue Shield of California Foundation.
 


 

Friday, September 6, 2013

Keeping the Community and its Economy Healthy


The nation's network of over 1,200 Community Health Centers offers a successful model for health care delivery that result in both improved patient access and significant local economic returns. In a new article by Capital Link in Communities & Banking magazine and an infographic available here, we report that health centers have collectively generated more than $23.4 billion in total economic activity for their local communities—an increase of 17.5 percent since 2009.

The analysis shows that health center growth benefits communities in multiple ways. Not only are health centers expanding access to care, they are stimulating the economy of their neighborhoods by building or renovating facilities in underserved areas, often with the benefit of adding employees.  Economic benefits result from the capital investment itself, from the growth of the health center’s operations and by attracting other development projects like pharmacies, banking facilities and retail upgrades. Health centers also purchase goods and services from local businesses, creating a ripple effect of additional economic stimulus throughout the broader community. Several New England health centers, profiled in the article, are excellent examples of how health centers offer quality care and stimulate the economy.

Monday, August 19, 2013

Health Centers Can Help Patients Understand the Insurance Options Offered through the ACA


Health centers are an essential component of health care reform not only as a source of primary health care but also as source of information about new health insurance options. The Affordable Care Act requires most Americans to have health insurance beginning January 1, 2014, imposing financial penalties (fees) on individuals who do not have coverage at that time.  As the enrollment window approaches, health centers have an opportunity to offer valuable guidance to their communities about the options available and the process of signing up for insurance. 

The latest issue of Capital Ink, Capital Link’s e-newsletter, contains an article about how health centers can help patients adjust to the health insurance changes brought by ACA implementation. Access it here.

Tuesday, August 13, 2013

Health Centers Across the Country Celebrate National Health Center Week


From August 11-17, health centers across the U.S. are celebrating National Health Center Week (NHCW) 2013, a campaign to raise awareness about the mission and accomplishments of America’s health centers as local solutions for affordable and accessible health care.  More than 1,000 events are scheduled.

President Barack Obama issued a proclamation officially designating this week as NHCW.  “Community Health Centers play a critical role in providing affordable, high-quality preventive and primary health care to millions of Americans,” he said.  “From urban centers to rural towns, they offer vital services regardless of ability to pay—services that help patients stay healthy and avoid emergency room visits. During National Health Center Week, we recognize health centers' significant contributions to keeping America healthy, and we offer our continuing support to the dedicated providers who operate them.”

In celebration of this event, Capital Link released a new infographic showing the economic impact and job growth of health centers nationally. Download the PDF from our website to share with local media, community supporters, or on social media.

Friday, August 9, 2013

New Infographic Shows Rising Economic Impact of Health Centers

To highlight the valuable work of health centers during National Health Center Week 2013, Capital Link is pleased to report that the powerful economic benefits health centers provide to their local communities are on the rise.

Check out Capital Link's new infographic showing the economic impact and job growth of health centers nationally. Download the PDF from our website to share with local media, community supporters, or on social media.


Potential New Markets Tax Credit Funding Increase


The President’s budget includes a windfall increase for the New Markets Tax Credit program with a request for a two-year cycle.  This increase would provide up to $8.5 billion in tax credit allocation for a two-year cycle 2014 and 2015.  That is a total $5 billion increase over the presently proposed $3.5 billion single-year cycle.  The application cycle for this improvement is in process now and applicants are looking for health center projects to include. 
 
The combining of two years’ worth of appropriation represents a large but fleeting window to finance your upcoming capital project with New Markets Tax Credits, which can provide approximately 20% of the value of project costs in the form of, effectively, a loan which is not repaid.  We will not see another funding opportunity like this for two years.

What Health Centers can do to Access the NMTC Program:

Capital Link is working to ensure that health centers are lined up with potential NMTC allocatees and prepared with financeable business plans prior to the announcement.  Once the announcement is made, allocation will be allotted to eligible projects very quickly, so health centers should prepare now.

Step 1:  Complete
the short questionnaire, including your contact information, health center name, brief project description with cost estimates, and project address including zip code so Capital Link can help you determine if your project is eligible for tax credit investment.  To learn if your project is eligible, please submit the survey as soon as possible.

Step 2:  Contact Mark Lurtz at
mlurtz@caplink.org or 636-244-3082 with any questions or to provide additional information about your project.

Background:  The New Markets Tax Credit Program:

In 2000, Congress passed legislation creating a new economic development tax credit program called New Markets Tax Credits (NMTC). This tax credit was designed to stimulate private investment in low-income communities. The program is administered by the Community Development Financial Institutions (CDFI) Fund under the US Department of the Treasury.
 
Through a series of competitive application cycles, the CDFI Fund allocates tax credits to Community Development Entities (CDEs).  As organizations focused on providing financing in economically-distressed areas, CDEs work to attract investors (primarily banks and large corporations), who provide them with capital in exchange for federal tax credits.  The CDEs, in turn, lend or invest this capital and other loans in businesses located in targeted census tracts to spur economic growth. 
 
Because the service areas of many federally qualified health centers (FQHCs) overlap these specific census tracts, health centers can often qualify to utilize NMTC investments as part of their capital financing.  NMTC transactions typically provide below-market, interest-only loans during the seven-year tax credit period; most transactions are also structured so that all or a portion of the original investment amount can become equity to the health center at the end of year seven—in effect, the NMTC portion of the investment does not need to be repaid. 
 
If you’d like more information about the program, visit our website for our publication “Spotlight on Capital Resources: New Markets Tax Credits,” available as a free download to health centers and PCAs.
 


Monday, June 24, 2013

Kaiser Study Indicates Community Health Centers Meet or Exceed National Quality Benchmarks

On June 21, the National Association of Community Health Centers announced the release of a brief entitled Quality of Care in Community Health Centers and Factors Associated with Performance by the Kaiser Commission on Medicaid and the Uninsured in collaboration with George Washington University. The brief indicates most Community Health Centers meet or exceed national benchmarks on key quality indicators. Using data from the 2010 Uniform Data System (UDS) reported by health centers and the 2008 Healthcare Effectiveness Data and Information Set (HEDIS) for Medicaid managed care organizations (MCOs), the study  highlights how health centers meet or exceed high-performance benchmarks set by MCOs, which also serve low-income populations, for three quality of care measures—diabetes control, blood pressure control, and receipt of a Pap test. The study also identifies factors that differ significantly between health centers with “high-performing” and “low performing” Medicaid MCO HEDIS rates.

The press release and link to the brief is available here.

Monday, June 3, 2013

America’s Health Rankings Announces New Healthy Seniors Report and Changes Ahead from BRFSS


By Rebecca Polan, Project Consultant
 
On May 29th, America’s Health Rankings announced the availability of a new report on the health of senior citizens, using the same state-by-state rankings released each year for the general population.  The web-based report draws from BRFSS data (the Behavioral Risk Factor Surveillance System), and delivers maps that demonstrate how the senior populations are faring in each state along health indicators including diabetes, obesity, and physical activity.  While Minnesota is the 5th healthiest state for the general population, its senior population is the healthiest in the nation.  The state of Mississippi is in last place for both populations. 

In its 2012 Annual Report, America’s Health Rankings announced that it has established a new baseline from which all future changes will be compared.  This is because the CDC’s BRFSS (the world’s largest ongoing telephone health survey) has changed its methods of gathering data to better reflect the growth of cell-phone only households (which includes this blogger!), as well as the increasing diversity of households within a state.  When BRFSS data is released later this year, the reported prevalence of many of the behavioral measures such as smoking, drinking, and diabetes, may look much higher than the previous year.  However, the difference may be partly due to this change in data collection and analysis method.  According to America’s Health Rankings, “The new estimates are superior to estimates collected in prior years and set the standard going forward in the new baseline.” 

Below are some links for identifying or updating your service area’s needs:

 
       County Health Rankings http://www.countyhealthrankings.org/

       Community Health Status Indicators http://communityhealth.hhs.gov/HomePage.aspx

       Behavioral Risk Factor Surveillance Survey (BRFSS) http://www.cdc.gov/BRFSS/

Tuesday, May 7, 2013

New Oregon Medicaid Study Asserts that Coverage is Key


Last week, the New England Journal of Medicine released a study of the Oregon Medicaid program, and the effects of enrollment on low-income individuals’ health and finances.  The ongoing study, launched in 2008, has tracked health indicators, mental health outcomes and financial well-being of a group of low-income individuals newly enrolled in Medicaid, and compared it to a group of uninsured individuals.   The headline is that after about two years, Medicaid appears to have substantially increased patients’ use of necessary medical services, reduced the rate of depression, and reduced the financial strain that previously limited their access to care.

The unfortunate situation in 2008 was that the Oregon Medicaid program was limited in capacity; however this served as an opportunity to create a control group to understand the effects of Medicaid coverage.  A lottery was created in 2008 for which 90,000 signed up, but not all of these were enrolled in Medicaid due to budget constraints, creating two populations (those enrolled and those not enrolled in Medicaid) to study.  So far results are mixed; according to the study, Medicaid enrollees are more likely to access health services and be diagnosed for diabetes, but blood pressure, cholesterol and diabetic blood sugar levels were the roughly the same among both populations.  The most dramatic difference was that Medicaid appears to reduce observed rates of depression by 30%, but the financial impact to low-income individuals was also significant:  Medicaid for the enrolled population virtually eliminated out-of-pocket catastrophic medical expenditures, reducing by 50% the probability of having to borrow money or skip paying other bills because of other medical expenses.

The links below provide more information and analysis of the recently released report:

The Oregon Health Insurance Experiment:  http://www.nber.org/oregon/index.html


Friday, April 26, 2013

New Markets Tax Credit Allocation Awards Announced


This week, the U.S. Department of the Treasury’s Community Development Financial Institutions Fund (CDFI Fund) announced $3.5 billion in New Markets Tax Credit (NMTC) awards nationwide. 85 organizations were awarded with tax credit allocation authority under the tenth award round of the NMTC Program.

As described by the CDFI Fund, the NMTC Program permits taxpayers to receive a credit against federal income taxes for making qualified equity investments in investment vehicles known as Community Development Entities (CDEs). These CDEs offer the credits to taxable investors in exchange for stock or a capital interest in the CDE. Because the service areas of many federally qualified health centers (“FQHCs” or “health centers”) overlap these specific census tracts, health centers can often qualify to utilize NMTC investments as part of their capital financing. NMTC transactions typically provide below-market, interest-only loans during the seven year tax credit period; most transactions are also structured so that all or a portion of the original investment amount can become equity to the health center at the end of year seven—in effect, the NMTC portion of the investment does not need to be repaid.

New Markets Tax Credit investments are place-based and must be located in eligible census tracts.  To find out if a site you have in mind is eligible for this program and to connect with a CDE interested in investing in your area, contact Mark Lurtz at mlurtz@caplink.org.

For more information on how health centers can take advantage of this program and the newly available allocation, read our publication “Spotlight on Capital Resources:  New Markets Tax Credits” available on our website http://www.caplink.org/resources.

Wednesday, April 10, 2013

New Markets Tax Credits Made Permanent in President’s Proposed Budget


Today, President Obama released his FY14 budget proposal detailing his federal spending priorities.  Among the many items included, the President proposed to permanently reauthorize the New Markets Tax Credit (NMTC) program at an annual amount of $5 billion. This represents another show of support for the NMTC program, which has helped many Community Health Centers generate additional equity for their projects.  

The NMTC program is slated to announce a new round of allocation credits later this month.  Contact Capital Link today to learn more about the program and how it may benefit your health center’s capital project.  For more information about the program and to learn how it works, health centers and PCAs can access Capital Link’s recently released Spotlight on Capital Resources: New Markets Tax Credits here: http://www.caplink.org/resources/publications.

Monday, April 8, 2013

Spring Webinar Series Announced!

Capital Link is continuing our series of webinars for health centers and PCAs this spring. These webinars have no charge, but participation is limited to the first 100 registrants. Register today! Contact Joe McKelvey at jmckelvey@caplink.org or 202-331-4602 with any questions.

Click here
to link to our registration form!

Behind the Sources and Uses Statement: A Simple Framework to Facilitate Capital Project Budgeting

Tuesday, May 7th, 2-3 PM EDT
Presenters: Dave Kleiber and Tony Skapinsky, Capital Link Project Consultants


Who are the People in Your Neighborhood? A Guide to Understanding (and Mapping!) Your Community
Wednesday, May 8th, 2-3 PM EDT
Presenter: Rebecca Polan, Capital Link Project Consultant
Strategic Planning
Tuesday, May 14th, 2-3 PM EDT
Presenter: Terry Glasscock, Capital Link Senior Project Consultant

For complete descriptions, visit http://www.caplink.org/resources/webinars


We hope you will join us!

Tuesday, March 26, 2013

Congress Approves Legislation Ensuring Continued Funding in Fiscal Year 2013 for Community Health Centers


Last week the Senate and House voted to pass the Consolidated and Further Continuing Appropriations Act of 2013, which funds the federal government for the remainder of fiscal year 2013. Under the legislation, the Health Centers program will receive a total programmatic level of nearly $3.1 billion for FY 2013. This allocation represents a $300 million increase in funding from FY 2012.

Of that $300 million, $48 million is allocated to base grant adjustments for existing health centers to ensure they are able to keep up with rising costs in the health care marketplace. More importantly, the legislation ensures the entire $300 million funding increase will be used immediately to address the demand for access to primary care services that health centers deliver, and provide for the expansion of care to 1.5 million new patients. Part of this funding may also be used to offset the impact of the sequester on existing health centers – ensuring no current services will be cut this year.

The legislation will allow health centers to expand access to primary care services nationwide in a time where demand is far outpacing current capacity. During the last expansion of health centers in FY2011, over 500 communities submitted applications for new Health Centers and were unable to be funded. Existing health centers have also not received a base grant adjustment since 2009.

The Consolidated and Further Continuing Appropriations Act includes nearly $1.6 billion allocated for health centers in FY13, which would be in addition to $1.5 billion previously allocated under the Affordable Care Act (ACA) for the program. Of the total $3.1 billion allocation, $48 million will go towards base grant adjustments for existing health centers. This represents a 1.7 percent funding increase for existing health centers. The funding for health centers within the ACA is scheduled to end in fiscal year 2015.

Source: the National Association of Community Health Centers

After Three Years: What is the Impact of the Affordable Care Act?


A new brief from the Kaiser Family Foundation provides a current snapshot of Community Health Centers three years after implementation of the Affordable Care Act. The brief focuses on recent developments that can be expected to have a significant impact on health center growth in the coming years. Read more at http://www.kff.org/uninsured/upload/8098-03_ES.pdf

Also, last Saturday the New York Times provided a report card on health care reform, including a reference to the investment in community health centers. Access the article here: http://www.nytimes.com/2013/03/24/opinion/sunday/report-card-on-health-care-reform.html?src=me&ref=general&_r=0

Saturday, March 16, 2013

Budget Talks: How the Latest Budget Proposals Will Affect Your Health Center


"Never base your budget requests on realistic assumptions, as this could lead to a decrease in your funding."

- Dilbert

This week House Republicans and Senate Democrats released competing budget blueprints for federal spending over the next ten years.  President Obama’s FY14 budget will also be released shortly.   In the weeks to come, you will certainly be hearing from both sides about the respective short and long-term merits of their proposals.  Although the two plans are quite different, they share a common thread—neither effectively addresses the national debt.

Despite how the short-term funding fights are ultimately resolved, even the rosiest long-term plans promise to eliminate the annual budget deficit over ten years.  Between now and then, we’ll continue adding to our $16+ Trillion national debt.  This reality means the pressure will be on squeeze the federal budget further and further. Although discretionary spending gets the lion’s share of attention, the major entitlements (Social Security, Medicare, and Medicaid) soak up the bulk of federal spending.

For many health centers that rely on Medicaid and Section 330 funding for a majority of their revenues, the outcome of these budget battles (and the ever-shrinking size of the overall federal pie) will force some to rethink their business models.  At the same time, the Affordable Care Act and broad demographic trends are creating a surge of new patients and new revenues for health centers.  Ultimately, health centers that take action now to strategically grow and plan for the future will be well-positioned—regardless of the federal budget situation.  Here are few ideas to get started:

What you can do now:

·         Evaluate your finances and balance sheet.  Conduct a sensitivity analysis to evaluate the impact of the possible changes to your health center’s funding streams, and develop a capitalization plan to ensure you have a sufficient cash “cushion” to weather the changes on the horizon.

·         Examine your market to determine opportunities for growth in light of new health insurance exchanges and/or Medicaid expansion.

·         Develop and implement a strategic plan for growth that includes an operational and program and staffing plan. 

·         Develop an outreach plan for connecting to the newly insured population, as well as a plan to assist your currently uninsured patients in navigating their new insurance options. 

·         Consider beefing up your development and fundraising efforts for ongoing support as well as capital support.

 

Friday, March 1, 2013

Resources to Track Affordable Care Act Implementation


Implementation of the Affordable Care Act (ACA) is proceeding as states and communities across the nation make key decisions about Medicaid Expansion, the Insurance Exchanges and Accountable Care Organization development.  Below is an overview of some of the latest resources available to track progress.

 Medicaid Expansion

Recent weeks have seen a lot of movement on the Medicaid Expansion front.  Newly expanding states include Florida, New Jersey, and Ohio while Wisconsin has announced that it will reject federal dollars but has a plan to decrease its uninsured population by half.  On the “No” side, North Carolina lawmakers recently voted to bar the Medicaid expansion, as did Pennsylvania’s governor, although recent news suggests that the governor may be having a change of heart.

To track the progress of each state there are a number of resources, including this link by The Advisory Board Company that includes the date of the announcement for or against the expansion by each state’s governor:  http://www.advisory.com/Daily-Briefing/2012/11/09/MedicaidMap

 The Center for American Progress is also tracking Medicaid expansion including data about how many patients may be affected in each state:


 Insurance Exchange Implementation

State ReForum is tracking exchange development via the following map:

 Accountable Care Organization Development

The National Academy for State Health Policy (NASHP) has developed an excellent overview of ACO development at the state level.  Focused on ACOs that incorporate Medicaid or CHIP populations, the map is a good place to start to learn more about how different states are approaching ACO development and implementation.


At Capital Link, we are also doing our best to track ACA adoption and progress and share best practices with health centers and Primary Care Associations.   Feel free to contact us for more information.