Community health centers should make the move toward value-based care

Value-based Care Scrabble
Community health centers should be allowed to experiment with new payment models, experts say.

As the healthcare industry moves toward value-based care, those payment principles can and should be applied to community health centers, albeit cautiously.

Patients treated at community health centers are often vulnerable, so their needs must be taken into account when applying payment reform to these organizations, according to a Viewpoint article published in the Journal of the American Medical Association.

“A switch to value-based care among CHCs could promote higher-quality, more efficient and more patient-centric care,” the authors wrote. “Because of the vulnerability of patients served by CHCs, however, this shift must be done thoughtfully, while honoring the original intention of the prospective payment system—to protect safety net clinics from the volatility of Medicaid rates.”

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A number of states have begun to test alternative payment models in community health centers. In 2013, Oregon launched a pilot that ensured CHCs would receive a capitated rate for all Medicaid patients, to ensure they’re financially on par with other facilities employing value-based care models. However, the increased efficiency from value-based programs, like group visits and telemedicine, could lead to reduced costs.

Thus far, the first 10 centers in the program have seen promising results, according to the opinion piece. Emergency department and hospital use has “modestly” decreased, and improvements in quality, access and patient experience have been found. Following the early successes, Oregon expanded the program to other CHCs across the state. 

Oregon’s model could be an effective one for other states to emulate, according to the article, as it offers CHCs more options in how they provide care, with little-to-no downside financial risk.

Community health centers are facing uncertain financial times as health reform talks continue to center on repealing the Affordable Care Act. Many CHCs extended their reach under the ACA.