Giving Thought: Healthcare access for all

Anyone who has encountered an emergency healthcare situation can attest that these experiences can be incredibly costly. Of course, some incidents are unavoidable, but a significant percentage of emergency room visits can be avoided with preventative care. The Agency for Healthcare Research and Quality (AHRQ) estimates that unnecessary emergency department visits cost between $4.4 billion and $32 billion annually.

The growing number of individuals who rely on emergency services to treat preventable or non-emergency issues places an increasing burden on our healthcare system and taxpayers. It is no secret that the medical care system in our country is complex and widely agreed to be imperfect. There is no silver bullet to improving healthcare outcomes. Yet, there are organizations designed to reduce overall healthcare costs, increase access, and decrease the burden placed on emergency departments.

Community Health Centers (CHCs) or Federally Qualified Healthcare Centers (FQHCs) are one mechanism for increasing access to healthcare for all and serve as a vital part of the healthcare safety net. Nationally, these facilities provide preventive and primary care to medically underserved low-income populations, offering an important safety net for more than 28 million people annually. These centers have been around for over 50 years. They are eligible for federal funding by adhering to strict standards and regulations, including serving patients regardless of their ability to pay and offering a sliding scale pay structure.

Mountain Family Health Centers (MFHC) is a 501(c)(3) nonprofit CHC that provides high-quality, integrated primary medical, behavioral, and dental health care in Garfield, Eagle, and Pitkin Counties. It serves more than 20,000 patients annually in its service area. MFHC has operated five hub clinics and five school-based health centers until last month when it was forced to close the doors on two of its SBHCs.

The difficult decision to close these two safety net clinics came after other budget cuts, including hiring freezes, suspension of employer retirement contributions, and staff reductions, were made to ensure the organization’s sustainability and financial health as it continues to adjust to changes in accessing Medicaid over the past 18 months.

“Within the past year in Colorado, more than 500,000 individuals have lost access to Medicaid coverage. At Mountain Family Health Centers, over 2,000 patients have lost Medicaid coverage due to federal changes and cannot get re-enrolled or identify other coverage options. In fact, Mountain Family’s current payer mix is nearly identical to what it was before expanding Medicaid through the Affordable Care Act in 2013 (47 % uninsured, 28 % Medicaid). This loss in coverage has resulted in a $1.5M in lost revenue for Mountain Family. As a Community Health Center, these patients have access to a sliding fee scale that accounts for income levels to provide discounted care, subsidized through donations and Mountain Family’s Health for All Fund,” according to Dustin Moyer, CEO of MFHC.

In Colorado, about 70 SBHCs are working to provide integrated primary care services to pediatric patients. SBHCs allow students and their families to easily access care in a familiar and comfortable environment with reduced barriers. Research shows the presence of SBHCs can reduce absences, improve educational outcomes, and increase graduation rates. MFHC has provided almost 7,500 visits to over 3,000 unique patients at one of their SBHCs in the last twelve months. Closing the two centers will undoubtedly reduce the number of students they can serve.

“The loss of insurance coverage for these patients adds to the already significant number of uninsured patients that Mountain Family serves. The uninsurance rate is higher in the Roaring Fork, Colorado, and Eagle River valleys than many other communities in Colorado due to higher wages that push families out of Medicaid coverage eligibility yet don’t cover the cost of private coverage. The decline in Medicaid coverage has led to barriers to care for our patients who need specialty or hospital services and a significant financial challenge for Mountain Family,” shared Moyer.

Access to medical care is essential for a thriving community. MFHC’s CEO and board members are working to help pass policy initiatives at the state and federal levels that will help restore Medicaid coverage and increase funding for its critical safety-net role. While philanthropy is not a long-term solution to these challenges, supporting MFHC’s continued service to our community is vital while long-term policy solutions are pursued in tandem. Support for Mountain Family’s Health for All Fund or its general operations will allow their dedicated staff to continue living their mission of improving the health of our community by providing equitable and affordable medical, behavioral, and dental healthcare for all.

Allison Alexander is the director strategic partnerships and communication at Aspen Community Foundation. ACF, with the support of its donors, works with a number of non-profits in the Roaring Fork and Colorado River valleys. Throughout the year, we will work to highlight non-profits in the region.