Last fall, when I was writing about my Cambridge Management Group (CMG) colleagues' work in helping to turn around a financially troubled Federally Qualified Health Center (FQHC) called Community Health Connections, based in Fitchburg, Mass., I learned about the role these centers play in addressing changing American health-care demographics in general and illness — especially chronic illness — in low-income populations in particular. Such centers will continue to face reimbursement and other issues as the restructuring of the health sector accelerates. The Affordable Care Act, in increasing the emphasis on primary care while more closely integrating it with acute care, will almost certainly increase the importance of FQHC’s and other clinics. With all the publicity about trying to get everyone signed up for insurance to use at physicians' offices and hospitals, we should keep in mind the need for facilities that are neither hospitals nor physician-group offices in treating underserved populations in places like the old mill towns of north central Massachusetts, with their high incidence of poor behavioral health and such related chronic diseases as diabetes, and sluggish economies.
Such institutions will have their hands full overcoming the clinical, financial and administrative challenges of meeting new federal and state health-care reform mandates while refocusing the payment structure on fee for value and away from fee for service in a new, far more accountable and evidence-based health-care sector.
Who knows what it will all look like in five years?
-- Robert Whitcomb