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New Analysis: Expanding Medicaid Would Increase CHC Reimbursement Revenue by 32% on Average

Monday, August 08, 2022

***Media Release*** 

August 8, 2022 

Contacts: Stacie Borrello, NCCHCA Communications & External Affairs Manager |  borrellos@ncchca.org, 919-996-9208; Brendan Riley, NCCHCA VP, Government Relations & External Affairs | rileyb@ncchca.org, 919-469-1116                     

Expanding Medicaid Would Increase Community Health Center Reimbursement Revenue by 32% on Average, New Analysis Finds 

Passing Medicaid Expansion Would Create Jobs in the Health Care Workforce and Expand Care Access in Rural and Underserved Communities 

Click to view and download the August 2022 Issue Brief: More Than an Insurance Card: How Medicaid expansion will increase the services of NC Community Health Centers and improve health outcomes. 

A new analysis of North Carolina Community Health Center data released this week shows that expanding Medicaid would not only directly benefit individuals gaining coverage, but it would also significantly increase revenue for North Carolina’s Community Health Centers (CHCs), allowing health centers to expand services and serve more patients. On average, net increases in reimbursements to CHCs would jump by 32.2 percent annually—for health care services they are already providing to their uninsured patients.  

CHCs play an important role as safety-net providers in medically underserved communities. While these Centers do their job well with limited resources, they face challenges because North Carolina has not yet expanded Medicaid. While CHCs are the provider of choice for hundreds of thousands of insured patients, an average of 40 percent of CHC patients are uninsured, putting a strain on CHC operating budgets. 

Because CHCs are required to reinvest all non-grant funds into programs that expand care access for the medically underserved, expanding Medicaid will promote financial stability for these critical safety net providers and allow them to increase capacity. 

“Under Medicaid expansion, we would be getting an additional $3-4 million a year in revenue from Medicaid. Those are dollars that Federally Qualified Health Centers will reinvest into new services and new practice locations,” said Chris Vann, chief development officer at CommWell Health, a Community Health Center with sites in five counties throughout the southeastern region of North Carolina. 

Medicaid expansion would also enable CHCs to make investments in expanding access to care by recruiting more providers to rural communities and expanding service lines like behavioral health and Medication Assisted Treatment (MAT) services. 

“With Medicaid expansion, we can add comprehensive specialties such as cardiology, podiatry, or ophthalmology practices to support our patients with comorbid conditions that we see frequently, like hypertension and diabetes,” said Scot McCray, CEO of Advance Community Health in Raleigh. 

By keeping patients out of the ER and preventing hospitalizations, CHCs help reduce health care spending by approximately 29 percent per patient per year, making health centers a remarkable investment for health care dollars. 

“While we understand that some lawmakers are concerned that expanding Medicaid would create a strain on provider capacity, our research shows that Medicaid expansion would, in fact, bolster our providers’ capacity. Medicaid expansion would mean that our Community Health Centers, who now serve a significant portion of uninsured patients, would receive reimbursements for care that was previously uncompensated, allowing health centers to increase capacity by hiring more staff and expanding programs to serve more patients,” said Brendan Riley, NCCHCA’s Vice President of Government Relations & External Affairs. 

For a detailed look at how Medicaid Expansion would impact Community Health Centers and their patients, refer to the North Carolina Community Health Center Association’s August 2022 Issue Brief: More Than an Insurance Card: How Medicaid expansion will increase the services of NC Community Health Centers and improve health outcomes. 

About CHCs: Federally Qualified Health Centers (FQHCs), also known as Community Health Centers (CHCs), which provide integrated primary medical, dental, pharmacy, behavioral health, and enabling services to more than 743,000 people in the state, regardless of their insurance status or ability to pay. By mission, Community Health Centers provide high-quality care in rural and medically underserved communities and to vulnerable populations, and as such are the backbone of the primary care safety net in North Carolina.

About NCCHCA: The North Carolina Community Health Center Association represents 42 Federally Qualified Health Center (FQHC) member organizations that provide integrated medical, dental, pharmacy, behavioral health, and enabling services to more than 743,000 patients at over 370 clinical service sites in 85 N.C. counties.

Click the link to view and download the two-page Issue Brief: More Than an Insurance Card: How Medicaid expansion will increase the services of NC Community Health Centers and improve health outcomes

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