PHILADELPHIA – Federally Qualified Health Centers (FQHCs) granted new patient appointments to Medicaid beneficiaries and uninsured patients at higher rates than other primary care practices (non-FQHCs), in addition to charging less for visits, according to results of a new 10-state University of Pennsylvania study published this month in Medical Care.
Using data from a previous "secret shopper" study conducted in 2012 and 2013, the investigators found that FQHCs — community health clinics that receive federal funding to provide primary care access to underserved populations — granted appointments to 80 percent of callers posing as Medicaid patients, while only 56 percent of callers who reported having Medicaid insurance were able to get an appointment at other types of primary care practices. When callers to the same group of practices volunteered other types of insurance, they were able to schedule appointments in those practices about 80 percent of the time. The study also found that nearly 70 percent of FQHCs provided lower cost ($100 or less) visits to uninsured patients, compared with only 40 percent at the same fee level at the non-FQHC practices studied.
The study, led by a team of physician scientists and public policy researchers at the University of Pennsylvania's Perelman School of Medicine and Leonard Davis Institute of Health Economics, utilized trained auditors, posing as patients requesting the first available new patient appointment. The callers were randomized to make 10,904 calls to primary care providers — including 544 calls to FQHCs.
"The higher acceptance rates of Medicaid and uninsured patients seems to indicate that Federally Qualified Health Centers will be an important source of primary care for these underserved populations moving forward, as more patients become insured under the Affordable Care Act," said lead study author Michael R. Richards, MD, PhD, MPH, a fellow in the Leonard Davis Institute of Health Economics, noting that the Affordable Care Act includes $11 billion in funding over five years to bolster the capacity of these centers to meet increased demand for primary care services. "This study suggests that FQHCs provide better availability and lower-cost options for these new patients, so it will be important to continue tracking FQHCs' accommodation of patients from these insurance groups in the early years of health care reform."
While the study also examined the difference between FQHCs and non-FQHCs in the patients' wait times until the scheduled visit, researchers found no clear evidence that wait times were longer for the underserved groups at FQHCs that offered appointments more readily.
"It's encouraging to see that FQHCs are meeting the needs of these individuals in appointment availability, cost and wait times," said the study's senior author, Daniel Polsky, PhD, executive director of the Leonard Davis Institute of Health Economics. "There are a considerable number of patients who will be seeking primary care for the first time in many years now that they are insured, so it's crucial that the system is prepared for this increase, and FQHCs are a key part of the equation."
The study was supported by a grant from the Robert Wood Johnson Foundation.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 17 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2013 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2013, Penn Medicine provided $814 million to benefit our community.