JustCare

Tag: Federally Qualified Health Center

  • When you need care quickly, should you use a health clinic?

    When you need care quickly, should you use a health clinic?

    Sometimes you may need health care quickly. And, the question becomes where to go for that care. If you can’t reach your doctor, should you get treatment at a health clinic or urgent care center rather than your hospital’s emergency room? In situations that are not life-threatening and when you are not in a crisis, to save time and money, you should consider seeking care at a health clinic or urgent care center.

    Is there an FQHC near you? If you do not believe you are in an emergency situation and your doctor is not available to see you, you should consider getting care at a federally qualified health center (FQHC) if there is one near you. These health clinics are administered by the federal government and provide free and low-cost health care. Today, there are nearly 1,400 health centers providing services at 11,000 service delivery sites throughout the US.

    Is there a free or charitable health clinic near you? There are more than 1,200 free or charitable health clinics across the US. You might check to see whether there is one near you.

    What about a commercial walk-in clinic or an urgent care facility? There are more than 7,500 urgent care centers (where you can usually see a doctor) in the US today. There are also more than 2,800 commercial walk-in health clinics (where you typically see a nurse) located at pharmacies and retail stores like Walmart and Walgreens.

    Why go to an urgent care facility or walk-in clinic instead of an emergency room? If you have a common problem, such as a fever, an infection, a stomachache or a deep cut, ask yourself these questions:

    • What does my doctor recommend? Call your primary care doctor to see if he or she is available to see you. It is always best to have your primary care doctor providing your care. If that’s not possible, find out where the doctor recommends you go for treatment.
    • Is there an urgent care center or walk-in clinic near me? If so, can it provide the care I need? And, will my Medicare plan cover my care?
    • What will I pay out of pocket? The cost of your care at a walk-in clinic or urgent care center is likely to be much lower than at the local hospital emergency room or ER. However, if you have traditional Medicare, and supplemental coverage, it should cover your ER care. If you are in a Medicare Advantage plan with a high deductible, your health plan may deny coverage if it decides it was not an emergency. And, even if it covers your care, you will likely save money by avoiding the ER.
    • How long am I willing to wait to get care? The wait for care may be much shorter at a health clinic or urgent care facility than at an ER.

    Keep in mind that quality of care you receive is likely to vary significantly depending upon the care you need and the skills of the health care provider delivering the care.

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  • Congress must protect our community health centers

    Congress must protect our community health centers

    Every Thursday morning, I wake up excited for the 14-hour day I’m about to begin. My Thursdays are so long because that’s the day I work a second evening job at a Federally Qualified Health Center (FQHC) that serves New York City’s lesbian, gay, bisexual, transgender, and queer (LGBT+) population. Why am I so happy to work a longer day? Not because I am a glutton for punishment, but because the work is truly satisfying in the way that only feeling completely confident in the care I’m providing can make me feel.

    The FQHC I work at provides essential medical and mental health care to an often-vulnerable population. Beyond the stress of being LGBTQ+ in our society, the patients I see are mostly uninsured or on Medicaid. Many have HIV/AIDS, substance use problems, and/or significant mental illness. I see individuals from diverse backgrounds and all age groups, from trans youth struggling with histories of abuse or homelessness, to older gay men who survived the AIDS crisis and lost many loved ones. Each person comes with a painful yet inspiring story, filled with strength, resilience, and love.

    And the care provided at this clinic, like most FQHCs – also referred to as Community Health Centers (CHCs) – is not just “good for the safety net.” It is the highest quality; often better than many private practice settings on multiple quality measures. Why is this?

    First, the care is truly integrated. I share a single medical record and can easily communicate with my patients’ medical providers. This reduces the chances of errors and conflicting treatments, such as drug-drug interactions. Quality improvement initiatives from the medical clinic apply to the mental health clinic and vice versa.

    Second, as federally funded clinics that participate vigorously in the Medicaid program, CHCs are often the first to know about and participate in health systems improvements and innovations. Despite what some private providers might tell you, government does a lot more than add bureaucratic hurdles; it attempts to ensure that health care is delivered in a safe and equitable way, is informed by evidence and guidelines rather than idiosyncratic clinician ideas and habits, and is responsive to public health needs. For instance, CHCs were on the frontline during the AIDS crisis, and are now playing a similar role in responding to the opioid epidemic.

    Third, CHCs are often full of passionate, mission-driven clinicians who deeply believe in what they are doing and care about the populations they serve. At the CHC where I work, clinicians are constantly sharing recent evidence, clinical advice, and local resources relevant to the LGBTQ+ population. Wouldn’t you want to be cared for by a group of individuals who are passionate about serving you and continuously communicating about better ways to do so?

    Finally, CHCs specialize in providing high quality primary care, which has been shown to produce the best outcomes. They are beacons of well-coordinated, efficient medical care in our specialist-driven and siloed health care system. This translates to better care at a lower cost!

    There are more than 10,000 CHCs in the United States, providing care for about one in thirteen Americans (and an even higher proportion in some states). In addition to primary care and behavioral health (i.e., mental health and substance use) services, like those provided where I work, many CHCs also provide dental and vision care. For the reasons above, 86 percent of primary care providers at CHCs are satisfied with their work, and 73 percent of patients who use CHCs as their primary source of medical care feel that it is high quality.

    It is therefore not surprising that CHCs have long enjoyed strong bipartisan support. Regardless of your political leanings, CHCs are clearly a rare example of a great deal in American healthcare. However, during recent fights over funding the federal government that resulted in two brief shutdowns, the Community Health Center Fund expired on September 30, 2017, and was not reauthorized until February 9, 2018. The Continuing Resolution that reopened the government in January included funding for the Child Health Insurance Program (CHIP) but not CHCs.

    If Congress had not restored funding in the nick of time, the Department of Health and Human Services estimated that about a quarter of CHCs would have had to close, resulting in nine million people losing access to healthcare and 51,000 job losses. Many CHCs had already begun deferring important investments and delaying staff hiring.

    This barely averted tragedy has received far too little attention. Let’s not take our CHCs for granted ever again; let’s avoid this kind of near miss in the future.

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