How Health Care Reform Accounts for 32 Million New Patients

    Suzanne Cohen, Public Affairs Coordinator for the Health Federation of Philadelphia, joined PHAN last night as the special guest on our call: Expanding Access to Primary Care. Participants were treated to a rather comprehensive presentation on the provisions within the new law set to expand this access, particularly when it comes to community health centers.

    32 Million more Americans will have health insurance in 2014! Lives will be saved, money will be saved. But what is it going to mean in terms of primary care? Many of us already experience waiting times at doctors' offices, for example. For a country already experiencing provider shortage issues, how do you add another 32 million Americans to the system?

    First of all, there are already an unprecedented number of doctors being trained in the US. The Patient Protection and Affordable Care Act (PPACA) helps with this by establishing a loan forgiveness program that provides scholarships for doctors that chose to work in medically undeserved areas. Anyone in the medical field can tell you two things:
       1) Graduating from medical school means acquiring over $100,000 in loans.
       2) You can pay that off a lot faster by becoming a 'specialist' instead of a
           primary care doctor.
The loan forgiveness program establishes new and much needed incentives for doctors to go into primary care.

    Cohen introduced us to an innovative program established by the PPACA that will help shift the focus of training for some new doctors from hospital care to primary care: allowing physicians the option of doing an entire residency in a health clinic. The new health care law also increases reimbursements through Medicare and Medicaid for providers in under-served areas. 

    Allocateing additional funding for federally qualified health centers (FQHCs) is another effective way to increase access to primary care.  FQHCs already have a track record of expanding access to care in a medically under-served area for over 45 years. And they do this with a real focus on holistic health care which coincides with the PPACA's commitment to integrated care.  Currently, 2,500 sites serve approximately 20 million Americans; many are uninsured, but not all. Given this, additional funding for FQHCs just makes sense.

    The 11 billion to be distributed over the next 5 years will be allocated through various grant competitions. Many of these have already started. There will be grants available for new health center sites, existing organizations to develop new clinics, expanding existing health centers to include things like dental care, for capitol costs like improving old buildings and to convert 'look-a-likes' to actual FQHCs. (FQHCs must have a board comprised of 51% patients or consumers, all others are 'look-a-likes' and are frequently passed over for funding).

    There are lots of other programs designed to grow the number of providers across the country that we just didn't have time to get to into in this call. Grants designed specifically to attract physicians to rural areas, the United States Public Health Sciences Track and the Primary Care Extension Program area all examples of these. Cohen did discuss funding for additional support for school based health centers and money for nurse managed health care.

    PHAN's Tuesday Night Policy Call Series will continue next week with a look at "Everything You Didn't Know Was in the Bill.." The call will include discussion around the student loan piece, the calorie count provisions in health care reform and other fun reform facts.