COMMUNITY HEALTH CENTERS ARE PART OF AN INTRICATE ECOSYSTEM OF HEALTH CARE FOR ALASKANS
As a CEO of a mission-driven health care organization, I find myself deeply conflicted. I look at the diversity of health care needs that I see in our community every day— and I worry about how we as Alaskans are going to continue to meet those needs as we head into the future.
Fiscal realities require our government to make choices about how to spend a limited pool of resources, with those choices often based on a projected return on investment. At both the federal level, as well as here in Alaska, there is a deliberate discussion among our elected officials regarding where those returns on investment are going to be the greatest—particularly in whether to continue to support funding to our expanded Medicaid program in Alaska.
Here is what I know: health is always a good return on investment.
Alaskans who are able to access affordable health care services are more likely to get care before their health conditions worsen to a point where they require emergency treatment. They’re less likely to miss work due to health concerns and are more likely to make meaningful contributions to our community.
TAMMY GREEN, MPH
At the Anchorage Neighborhood Health Center (ANHC), we strive to address the unmet primary health care needs of our community. We see everyone from the elderly, to new mothers and young children. In a month, we translate more than forty different languages and provide every health care service from setting broken bones, to treating diabetes, fixing toothaches, giving flu shots, and more.
We provide these services as a Federally Qualified Community Health Center. This means that we offer a range of extra support services and discounts to patients, which allow us to serve our community-wide mission of improving wellness by providing high quality, compassionate health care, regardless of ability to pay.
We are Alaska’s first and largest community health center, established in 1974, and we served over 13,000 unique patients in 2016, through more than 45,000 visits. As you can imagine, this was no small task, and we want to be fully prepared to continue to meet the challenges that are coming.
Think of ANHC as part of an ecosystem of health care in Alaska. This ecosystem, through its numerous distinct providers, has a diversified set of payment models, multiple health care delivery models, and a solid foundation of primary care services provided with high quality. We need all of those elements present in order to be able to deliver effective health care to our community.
When lawmakers at all levels of government debate reducing services, limiting reimbursement rates for care or eliminating programs that provide health services to Alaskans, Alaska’s Community Health Centers are frequently featured in their plans as the safety-net to capture individuals losing coverage under other resources. As much as we want to be able to serve the health of every Alaskan, our organization alone simply does not have the capacity to provide care for everyone who needs it, unless we have the support of a thriving and interconnected system of care.
I’ve worked in health-related industries for almost 30 years, and while some of these proposed changes at the state and national level are made to sound like an ‘easy fix’ or a quick swap, the reality is that they are not. Changes of this magnitude require new staffing models, expansion of facilities and more; they cannot happen quickly without the very real risk of leaving members of our community without access to care. This risk is too serious to ignore.
More than 27,000 Alaskans gained access to primary care under the expansion of Medicaid in 2015, and many more gained access to essential oral and behavioral health services with that same expansion.
A reduction in covered Medicaid services and Medicaid funding in Alaska means that fewer people will have access to care. Additionally, proposals to remove programs or providers from our system of care, without the needed preparation and resources, simply shifts patients into a different part of the system, usually at a greater cost.
Research has demonstrated that an overburdened safety-net primary care system ultimately results in increased emergency room visits by those who can afford it the least. I’ll ask you to consider: who is ultimately going to pay for those costs?
There’s not only a hardship to those who may fall between the cracks, but adverse long-term consequences for the health of our entire community. This is not the time to be passive or silent, as the health of all Alaskans requires your attention. Right now.
I’d like to challenge each of us to cultivate a greater curiosity and an appetite for the facts. This is something that impacts everyone, as health and wellbeing are necessary to cultivate a thriving community.
As Alaskans, we value the recommendations of friends, neighbors, and colleagues; reach out to someone in health care who you trust and ask them questions. Gather information from credible sources and reliable reports. Make an informed opinion about the real impacts surrounding current health care legislation and proposed budget cuts—and then most importantly, make your thoughts known to the lawmakers who represent you.
We are all Alaskans, and we are all in this together. Please—don’t be silent on this issue. It’s up to each of us to become educated and to make our voices heard.
Tammy Green is the Chief Executive Officer for the Anchorage Neighborhood Health Center and has worked in health-related fields in Alaska for nearly 25 years. She has a Master’s Degree in Public Health.
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