A headline on the front page of the Metropolitan section of a recent Sunday New York Times strongly resonated with the community health centers in neighboring Connecticut. “Hospitals Both Strained and Essential” (Nov. 20, 2022) details the struggles of New York City’s safety net hospitals to care for the city’s poorest communities.
A poor payer mix — fewer than 15% of patients have traditional commercial healthcare coverage — combined with physical facilities in dire need of upgrades, salaries and benefits that fail to compete with nearby for-profit and academic healthcare institutions contribute to the bleak outlook. This resonated with us as CEOs of Connecticut’s community health centers because we, too, experience this every day.
However, as the headline hinted, there is growing recognition in New York that these facilities are essential. As horrific and unsettling as the impact of COVID-19 was, there is a growing agreement that the loss of life and its associated economic impact would have been far worse had it not been for the institutions committed to caring for the most vulnerable communities. New York leadership is starting to “get it” — for the coming fiscal year, New York Gov. Kathy Hochul has “budgeted twice as much and has asked the federal government to increase the Medicaid rates….”
Like the healthcare systems described in this article, community health centers in Connecticut also struggle with outdated physical facilities, poor payer mix and salary demands that fail to keep pace with well-resourced healthcare systems.
Collectively, community health centers in Connecticut care for over 415,000 residents, approximately 11% of the state’s population. We serve over 250,000 Medicaid patients, more than 25% of the HUSKY population. Our Medicaid payments are based on a federally mandated system established in 2001 and tied to the 2001 costs of care. Those rates increase annually on what is deceptively called an “inflationary” figure, the Medicare Economic Index (MEI).
For the coming year, the MEI is 2.1%, the highest in recent memory. Yet as is well-known, inflation currently is over 8%. Last year the MEI was 1.4% when national inflation was close to 5%. Couple these fiscal realities with the fact that health centers also care for the majority of Connecticut’s uninsured residents and the struggle is glaringly obvious.
The Lamont administration’s stated commitment to dealing with racial inequities is widely touted; however, health centers have repeatedly requested rate increases to keep up with increased services and inflation, but requests to date have gone unheeded.
Health centers provide a wide range of essential primary care services, including dental care, behavioral health, substance use disorders, vision, care coordination and more. What’s more, the quality of care provided by community health centers is exemplary — the annual Healthcare Effectiveness Data and Information Set (HEDIS) report from the state indicates health centers exceed statewide quality measures nearly 70% of the time.
State leaders often point to federal grants as reasons for not recognizing the fiscal challenges of the health centers. Efforts to point out that grants are not guaranteed income, and that they are usually earmarked for a single, time-limited specific project, typically fall on deaf ears at the Department of Social Services (DSS), the state agency with authority over our Medicaid program.
During the COVID pandemic, health centers stepped up to the plate. We tested, vaccinated and treated hundreds of thousands of Connecticut residents — in short, we helped keep those who came to our doors healthy during one of the worst public health crises in our nation’s history.
We currently face the same inflationary pressures present throughout the country, indeed the world. It is time for Governor Lamont to heed the lessons learned from New York state and provide much needed assistance to Connecticut’s safety net system of Community Health Centers.
This opinion piece was drafted and signed by the CEOs of 15 different community health centers in Connecticut. Their names are listed below.
Community Health & Wellness Center of Greater Torrington, Inc.
Optimus Health Care, Inc.
United Community & Family Services, Inc.
Fair Haven Community Health Care
Southwest Community Health Center, Inc.
Charter Oak Health Center, Inc.
Generations Family Health Center, Inc.
Generations Family Health Center, Inc.
Community Health Services, Inc.
First Choice Health Centers, Inc.
Cornell Scott-Hill Health Corporation
StayWell Health Center, Inc.
Family Centers, Inc.
Wheeler Clinic, Inc.
Norwalk Community Health Center