Kulesher Robert R
Department of Health Services and Information Management, College of Allied Health Sciences, East Carolina University, Greenville, NC 27858, USA.
Health Care Manag (Frederick). 2013 Apr-Jun;32(2):99-106. doi: 10.1097/HCM.0b013e31828ef5d5.
The impact of recently passed health reform legislation may cause substantial changes in community health center (CHC) operations. The new legislation provides federal funding for center expansion, increased Medicaid enrollment, enhanced Medicare payments, training to increase primary care providers, and incentives to develop CHCs as accountable care organizations. Health reform could place CHCs in a vulnerable financial situation. Newly insured patients may seek care at private providers, whereas CHCs are left caring only for the uninsured. Thus, CHCs are unable to benefit from enhanced insurance payments needed to offset care given to the uninsured. Conversely, if CHCs participate in developing comprehensive care networks for low-income populations by strengthening referral networks, developing primary medical care homes and accountable care organizations, and investing in infrastructure, then health center medical care will be a desired option for the newly insured, and a robust safety-net system may result.
近期通过的医疗改革立法可能会给社区卫生中心（CHC）的运营带来重大变化。新立法为中心扩张提供联邦资金、增加医疗补助登记人数、提高医疗保险支付额度、开展培训以增加初级保健提供者，并激励将社区卫生中心发展成为可问责医疗组织。医疗改革可能会使社区卫生中心陷入脆弱的财务状况。新参保患者可能会寻求私人医疗服务提供者的治疗，而社区卫生中心只能照顾未参保者。因此，社区卫生中心无法从用于抵消为未参保者提供医疗服务所需的增加的保险支付中受益。相反，如果社区卫生中心通过加强转诊网络、发展初级医疗之家和可问责医疗组织以及投资基础设施来参与为低收入人群建立综合医疗网络，那么健康中心医疗服务将成为新参保者的理想选择，并且可能会形成一个强大的安全网系统。
