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.