Community care clinic now accepting public insurance
summit daily news
After waiting just under five months for an answer, Summit Community Care Clinic got word Wednesday it was approved for a federal designation that allows it to serve patients with public health insurance, and keeps the office financially viable heading into the future.
The designation is a Federally Qualified Health Center Look-Alike, which gives the clinic a higher rate of federal reimbursement to see Medicaid, Medicare and Child Health Plan Plus patients than other entities.
“There’s a lot of people who could not get their medical needs met if we didn’t have a safety net clinic,” said Sarah Vaine, care clinic executive director. “The FQHC Look-Alike status just helps us ensure that we can continue to do that over time.”
For patients, the new designation means more choice. Since public health insurance reimbursements for physicians aren’t as good as private insurance, more and more doctors, especially specialists, are not willing to take Medicare or Medicare anymore, Vaine said.
“So those people with public insurance are increasingly starting to feel like uninsured, because if you have insurance and no one takes it, then you’re essentially uninsured,” Vaine said. “This will help give more access to those people with public insurances.”
More benefits for patients that come along with the designation: access to reduced-cost medications, and expanded hours at the clinic. As part of the requirements, the office is now open on Tuesday and Thursday evenings, and all day Saturday.
“As we’re able to, and as need merits, we’ll probably expand the hours even more,” Vaine said.
For the office, those higher reimbursements – which are given with the requirement that the clinic serves every low-income and uninsured person who walks through the door, regardless of the ability to pay (the clinic already serves the uninsured and underinsured) – help keep the nonprofit afloat financially.
“I think we have been worried about our ability to keep our doors open without collecting any payment for services from third-party payers,” Vaine said. “This just helps us diversify our funding services … It will just ensure that our organization stays financially viable”
The care clinic has historically been a community-funded safety net program, and before, was about 80 percent grant funded. Vaine said the office will still write grants and do fundraising, but will now be less dependent on those sources.
The new look-alike designation also lines the clinic up for another one: a Health Professional Shortages Area. The title means that providers would be eligible for federal loan repayment. Vaine said they already have a dentist lined up because of it.
“We’ve had all these dentists and physicians that have come to work with us in an area with a higher cost of living then other places, who couldn’t get loan repayment because we didn’t have that designation, and now they can,” she said. “So it allows us to recruit and retain more health care professionals to our area than we ever have before”
Vaine doesn’t foresee a huge initial surge of new patients; she believes the clinic serves many of those in need already.
“I do predict things will change especially in 2014 when all the pieces of the Affordable Care Act come to fruition. You’re going to have all these additional people eligible for Medicaid, then we may start getting people from other areas,” like Lake and Park counties, she said. “Our plan is as the need increases, to continue to expand in hours. We have the ability to expand the capacity in our current space quite a bit.”
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