Adverse Health Impacts

A state agency plan to change the way community health centers can draw down $50 million in indigent care funding could drive some centers out of business, shutting the door on a key part of Florida’s health care safety net in some communities. That was the message delivered by the Florida Association of Community Health Centers in a news conference call Tuesday afternoon.
Andrew Behrman, President & CEO of the Florida Association of Community Health Centers, was joined by the heads of three centers around the state to urge the state Agency for Health Care Administration (AHCA) to drop consideration of a proposal that would run all health center reimbursement payments through managed care organizations. They said the organizations would introduced inefficiency and potential loss of payments, at a time when many of the state’s centers are struggling to keep their doors open. AHCA is to discuss the requirement at a meeting tomorrow.
“Our centers represent the largest safety net provider system in the state, and without them uninsured or underinsured low-income Floridians would have nowhere to turn for their health care needs,” Behrman said. “The last thing these Floridians need is for their health care to be tied up in bureaucratic delays caused by unwarranted administrative hoops.”
Behrman was joined by Dr. Michael Gervasi, CEO of Florida Community Health Centers, based in West Palm Beach; Brad Herremans, CEO of Suncoast Community Health Center, based in Brandon; and Annie R. Neasman, CEO of Jessie Trice Community Health Center in Miami. Together, they called for AHCA keep the bureaucracy of managed care organizations out of the vital process of reimbursing community health centers for uncompensated care.
“It is simply no exaggeration to say that for thousands of people in our community, the work we perform is a matter of life and death,” Dr. Gervasi said. He noted that without community health centers, most of those patients would have no choice but to seek treatment in an emergency room, and considerably higher cost to taxpayers.
According to figures compiled by the association, community health centers have saved Florida taxpayers more than $1.6 billion that otherwise would be spent to care for poor residents in more costly emergency rooms. The 48 centers are Florida’s Federally Qualified Health Centers (FQHCs), and together they treated over 1.4 million patients last year. Their patients included 41 percent who receive Medicaid, 7 percent Medicare, 36 percent uninsured, and 16 percent with commercial or VA coverage.
State funding for the FQHCs was cut from $9 million in 2016-17 to $6 million in 2017-18, funds that will be supplemented by $50 million included in the $1.5 billion LIP fund.
Neasman, who is a registered nurse, said some of Florida’s community health centers are already owed $1 million or more in reimbursements for care they already provided to patients.
“If those funds don’t flow soon, some centers will be in real trouble,” she said. “There’s no incentive for managed care companies to make it easy for our centers to receive the money we’re owed. This inherent conflict may serve the interests of the managed care organizations, but it doesn’t help us – and it sure doesn’t help our patients.”
Herremans noted that Florida’s FQHCs must treat everyone who walks in the door. “That’s a requirement, but it’s also our mission. So we will continue to do so, with or without the money, for as long as we can,” he said. “But by erecting unnecessary barriers that keep us from accessing these funds, Florida may suffer the unintended consequence of driving some of these centers out of business.”