Specialty Care in Demand: CCN Viable Solution, Yet Funding Required

Specialty Care in Demand: CCN Viable Solution, Yet Funding Required

A report released today by the Commonwealth Fund called Enhancing the Capacity of Community Health Centers to Achieve High Performance documents the importance of the relationship between health centers and hospitals for access to specialty care. The report noted in a survey of almost 800 health centers that 49 percent of centers had difficulty with specialty care referrals for Medicare patients, 71 percent had difficulty for Medicaid patients and 91 percent had difficulty for uninsured patients. This finding alone indicates a significant short-coming or gap in the current delivery system that is not being met for patients with specialty care needs. In each instance, however, health centers that had relationships with hospitals had an easier time getting offsite specialty referrals as compared to centers without relationships with hospitals. Safety net hospitals who partner with health centers are meeting an important need in hundreds of communities across the country.

The specialty care gap will only worsen as more resources are put into primary care–$11 billion in new funding for health centers is provided in health reform legislation–essentially funneling more demand into a care pipeline that is already overburdened. When someone served by a new health center is diagnosed with a chronic disease or acute illness requiring follow up, that person will enter a queue for specialty care that is already backlogged.

Two policy conclusions emerge. The first policy recommendation is cited in the report, which calls for “developing a policy to support and facilitate health centers, specialty care providers, and public hospitals to formalize referral and coordination partnerships so that they can ensure mutual accountability for vulnerable patients.” Such a policy already exists in health reform legislation via Community Based Collaborative Care networks (CCN), a priority of NAPH’s in health reform. CCNs are networks of safety net providers (hospitals and health centers) that integrate and coordinate care to low-income populations. The second policy conclusion to this report is to adequately fund integrated care networks of hospitals and health centers via CCNs to assure that patients with serious health care problems requiring specialty care get the care they need in a timely manner. If the CCN program is not funded at a significant level, policymakers must find other means to address the specialty care gap.

This Post does not have any comments.

Add a new Comment