Health reform: How community health centers could offer better access to subspecialty care

August 30, 2012

The Affordable Care Act will fund more community health centers, making primary care more accessible to the underserved. But this may not necessarily lead to better access to subspecialty care.

In a new study, researchers from the David Geffen School of Medicine at UCLA and colleagues investigated the ways in which centers access subspecialty care. They identified six major models and determined which of those six offered the best access:

Tin cup
Center providers rely on with informal networks of subspecialists (the most prevalent ).

Hospital partnership
Center has a contract with a community hospital for subspecialty care.

Buy your own
Center hires subspecialists.

Telehealth
Telecommunications equipment is used to connect patients with subspecialists.

Teaching community
Centers train primary-care resident physicians and integrate subspecialists as faculty.

Integrated system
Centers are integrated with local government health systems or safety-net hospitals having subspecialist networks.

Of the six, the researchers found that the "integrated system" model offered the most comprehensive access to subspecialty care.

Payment reform is needed to move community toward becoming part of integrated systems. Two new initiatives of the Centers for Medicare and Medicaid Services (CMS) can help. First, the State Innovation Models initiative will provide $275 million for states to plan, design and test new payment and delivery system models that aim to involve all payers and providers in the state. Also, the CMS has issued guidance describing pathways for how states can design and implement integrated care models for Medicaid populations. The new research offers guidance for states in creating such models.

The research is published in the August issue of the journal Health Affairs.

Explore further: Time to stimulate, not limit, pediatric subspecialist training

More information: content.healthaffairs.org/cont … t/31/8/1708.abstract

Related Stories

Time to stimulate, not limit, pediatric subspecialist training

May 9, 2011
As Washington looks for ways to trim budget costs, one of the programs facing continued threats of cuts or elimination is the Children's Hospitals Graduate Medical Education (CHGME) Program, a program administered by the ...

Recommended for you

New shoe makes running 4 percent easier, 2-hour marathon possible, study shows

November 17, 2017
Eleven days after Boulder-born Shalane Flanagan won the New York City Marathon in new state-of-the-art racing flats known as "4%s," University of Colorado Boulder researchers have published the study that inspired the shoes' ...

Vaping while pregnant could cause craniofacial birth defects, study shows

November 16, 2017
Using e-cigarettes during pregnancy could cause birth defects of the oral cavity and face, according to a recent Virginia Commonwealth University study.

Study: For older women, every movement matters

November 16, 2017
Folding your laundry or doing the dishes might not be the most enjoyable parts of your day. But simple activities like these may help prolong your life, according to the findings of a new study in older women led by the University ...

When vegetables are closer in price to chips, people eat healthier, study finds

November 16, 2017
When healthier food, like vegetables and dairy products, is pricier compared to unhealthy items, like salty snacks and sugary sweets, Americans are significantly less likely to have a high-quality diet, a new Drexel University ...

Children's exposure to secondhand smoke may be vastly underestimated by parents

November 15, 2017
Four out of 10 children in the US are exposed to secondhand smoke, according to the American Heart Association. A new Tel Aviv University study suggests that parents who smoke mistakenly rely on their own physical senses ...

How pomegranate extract alters breast cancer stem cell properties

November 15, 2017
A University at Albany research team has found evidence suggesting that the same antioxidant that gives pomegranate fruit their vibrant red color can alter the characteristics of breast cancer stem cells, showing the superfood's ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.