Funding growth drives community health center services

Health Affairs

Volumn 29, Issue 2, 2010, Pages 289-296

  Lo Sasso, Anthony T ^a   Byck, Gayle R ^a  

^a UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COUNSELING; FUNDING; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH CENTER; HEALTH INSURANCE; HEALTH SERVICE; HOSPITAL PERSONNEL; HUMAN; MEDICAL INFORMATION; MENTAL HEALTH; PATIENT CARE; REGRESSION ANALYSIS; REVIEW; SUBSTANCE ABUSE;

COMMUNITY HEALTH CENTERS; COMMUNITY HEALTH SERVICES; FINANCING, GOVERNMENT; HEALTH CARE REFORM; HEALTH SERVICES ACCESSIBILITY; HUMANS; MEDICALLY UNINSURED; UNITED STATES;

EID: 77957367139     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2008.0265     Document Type: Review

References (31)

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3. Much of this recent growth was attributable to the Health Centers Initiative, which began in 2002 and increased funding from just over $1 billion in fiscal year 2001 to nearly $2 billion in fiscal year 2007. Health Resources and Services Administration. The Health Center Program: The President's Health Center Initiative [Internet]. Washington (DC): HRSA; [cited 2010 Jan 5]. Available from: http://bphc.hrsa.gov/presidentsinitiative/
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25. Grant categories include migrant health center, community health center, health care for the homeless, public house primary care, as well as more recent mechanisms such as the Integrated Services Development Initiative and the Shared Integrated Management Information Systems. We added federal grant dollars reported for each of these key mechanisms for each federally qualified health center.
26. It is easy to imagine other potential scope-of-service measures-perhaps most notably the number of fulltime-equivalent staff employed at federally qualified health centers. Curiously, information on the health center workforce was made confidential beginning in 2001.
27. See Mechanic D, McAlpine DD, Olfson M. Changing patterns of psychiatric inpatient care in the United States, 1988-1994. Arch Gen Psychiatry. 1998;55:785-91.
28. National Association of State Mental Health Program Directors Research Institute Inc.. Closing and reorganizing state psychiatric hospitals: 2003. Alexandria (VA): NASHMHPD Research Institute; 2004.
29. Sliding-payment-scale adjustments (discounts) provided by a center are defined as "reductions to patient charges based on the patient's ability to pay, as determined by the grantee's sliding fee scale... [including] sliding fee discounts in required copayments, as applicable." Bad debt is defined as "any responsible payer may default on a payment due."
30. A concern regarding our model is the potential endogeneity of grant funding with respect to outcomes such as service provision and uncompensated care. For example, clinics that provide a lot of uncompensated care may be able to justify larger grants. Although this is a concern, two issues militate against concern over this "circularity." The first is that the inclusion of clinic fixed effects will account for the largely time-invariant nature of a clinic's being a large uncompensated care provider. The second is that federal grants increased by legislative fiat, which is largely exogenous to any specific clinic's needs.
31. To access the Online Appendix, click the Online Appendix link in the box to the right of the article online.