Affordable Care Act (ACA) ObamaCare

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1 Patient Protection and Affordable Care Act (ACA) ObamaCare Tito Izard, M.D. President & CEO Milwaukee Health Services, Inc. Clinical Associate Professor University of Wisconsin School of Medical And Public Health

2 President Obama s Original Goal for Healthcare Reform Access to Care Portability Bend Cost Curve

3 Urban Underserved... Metropolitan area containing a disproportionate percentage of ethnic minority communities or those with a substantial concentration of impoverished or working poor households.

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7 Pressures facing Working Poor and Middle Class Will work for Health Insurance

8 2008 Recession Hit 8.4 million jobs lost beginning December 2007 Unemployment rate peak at 10.2% nationally Nearly 23 million Americans were unemployed/ underemployed More than 6 million Americans had been out of work for more than 6 months

9 How will the ACA Health Law impact FQHC s?

10 Tito Izard, M.D. Chief Medical Officer Milwaukee Health Services, Inc.

11 Tito Izard, M.D. Chief Medical Officer Milwaukee Health Services, Inc.

12 Tito Izard, M.D. Chief Medical Officer Milwaukee Health Services, Inc.

13 What is a Community Health Center? Independent Non-profits Incorporates local community resources with federal funds to establish neighborhood clinics in both rural and urban areas around the country. Located in Health Professions Shortage Areas (HPSA) Designated as Federally Qualified Health Centers (FQHC) Unique community-based Board of Directors w/ 51% membership are CHC users of service Receives partial funding from feds (330 Grant) and other qualifying grants Creates opportunities to see all patients despite financial ability to pay

14 Community Health Centers offer cost-effective and affordable services Primary & Preventive Medical & Dental Services Health Education Community Outreach Pharmacy Services Behavioral Health Laboratory/Radiology Support Programs Medicaid/WIC Programs Translation Services Transportation Services

15 Role of CHC s within Communities Educate Families Evaluate Health & Wellness Alleviate Ailments Create Self-Sufficiency Advocate for Community needs and resources

16 Benefits of ACA to FQHC s Expand Centers to care for 40 millions Americans (currently about 18 million) $11 Billion over 5 years $9.5 B for new centers and expanded capacities $1.5 B for Capital Improvement and new Facilities 340-b purchase of medications at near cost Malpractice coverage through FTCA (Fed. Tort) Cost-based reimbursement for Medicaid patients only FQHC Medicare rates

17 State Children Health Insurance Program Poverty rate for children under 18 greater than any other age group Likely due to increase in single-parent families Provides Medicaid-like coverage for working poor families Participation in Vaccines For Children program

18 Benefits of ACA to FQHC s Cost Savings to Health Care System by: Reducing ER visits Hospitalizations Avoidable costly care Up to $122 B saved thru CHC s would save as much as $55 B for Medicaid over 5 yrs. Of that $32 B will be saved by Fed and rest by States Ku et al. Using Primary Care to Bend the Curve: The Effect of National Health Reform on Health Center Expansions. Geiger Gibson/RCHN Community Health Foundation. June Policy Research Brief No. 19

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20 Addressing the Workforce Shortage: Authorizes and appropriates the following annual amounts to a new National Health Service Corps Trust Fund: $290 million for FY 2011; $295 million for FY 2012; $300 million for FY 2013; $305 million for FY 2014; $310 million for FY TOTAL = $1.5 billion over five years

21 What are the challenges of an FQHC under the ACA? Uncertainty regarding shifting of patients throughout health system Accountable Care Organizations (ACO s) are not required to contract with all FQHCs in each community Immediate impact of Provider shortages in rural and urban areas. (Healthcare pipeline) Population shift in workforce and needs; Aging Nursing and Physicians practices Remaining 23 million people who are not covered. Illegal issue remains unaddressed. Costs and Sustainability for States and Fed govt

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