More Evidence That Community Health Centers Are Cost-effective

A new study by researchers from the George Washington University Milken Institute School of Public Health (Milken Institute SPH) found that overall annual expenditures for children receiving at least half of their care at community health centers (CHCs) were 35 percent lower than outlays for children whose families did not patronize CHCs.

“Community health centers are key strands in the health care safety net, providing primary and preventive care services to medically underserved communities regardless of income, insurance status or ability to pay,” said Leighton Ku, PhD, the study’s coauthor and professor in the Department of Health Policy and Management.  “CHCs care for one in 10 children nationwide and nearly four in 10 low-income children.”

Between 2010 and 2016, the number of children receiving care at CHCs grew by 29 percent, and the number of nonelderly adult patients expanded by 33 percent. In 2016, 15.7 million adults between the ages of 18 and 64 and 8.0 million children younger than 18 patronized CHCs for medical and mental health care, according to the Health Resources and Services Administration.

The study used cutting edge propensity score methods which seek to emulate findings that could be derived from a randomized experiment, typically considered the gold standard of research.  The analysis showed that children who received care at CHCs spent 35.3 percent less overall on medical care, including 40 percent lower expenditures on ambulatory care and 49.1 percent lower prescription drug outlays. Adults spent $529 less on hospital stays, according to the analysis.

“Our results support prior research that the CHC model of comprehensive, community-oriented primary care is efficient, particularly for pediatric and adolescent patients,” said Brian Bruen, the paper’s first author. He is a lead research scientist and lecturer, and he recently successfully defended his doctoral dissertation in public policy with a focus on health policy at the George Washington University. 

At the end of their paper, Bruen and Ku point out that federal funding for CHCs is set to expire at the end of the federal fiscal year on September 30. “Continued support for CHCs and for Medicbaid can ensure that this system of care remains vital and intact,” they say.

The Effects of Community Health Center Care on Medical Expenditures for Children and Adults" is published in the Journal of Ambulatory Care Management (April-June 2019).