►
Description
Original Webcast March 8, 2013 | Community health centers (CHCs) provide health care services for over 22 million people nationwide. As community-directed nonprofits, they provide primary health care and other services. Most of CHCs patients are poor and uninsured or enrolled in Medicaid. They also tend to be members of racial and ethnic minorities. Additionally, about half their patients reside in rural areas.
Over the last decade, community health centers have played an important role in the health system. In 2001, President George W. Bush made a significant commitment to expand the Health Centers Program, nearly doubling the number of health centers across the nation. The Affordable Care Act continues to expand the reach of community health centers in the U.S. health care system.
This webinar will explain how health centers operate and how their patient mix presents funding challenges. Health centers must rely heavily on third-party payer reimbursement (such as Medicaid, CHIP, and Medicare) — since one of the largest groups served by health centers – the uninsured – account for less than 6 percent of their total revenue. The webinar will also discuss how changes in Medicaid eligibility or benefits directly affect health centers and the biggest concerns facing health centers in the coming years
A
Good
afternoon
everyone,
my
name,
is
Lonnie
Edgar
and
I'm,
with
the
Joint
Committee
on
performance,
evaluation
and
expenditure
review
for
the
state
of
Mississippi.
On
behalf
of
the
National
Conference
of
State,
Legislatures
I
would
like
to
welcome
all
of
you
to
today's
webinar
entitled
community
health
centers
role
in
the
health
system
now
and
in
the
future.
A
Today's
webinar
will
explain
how
health
centers
operates
and
how
their
patient
mix
presents.
Funding
challenges.
Health
centers
must
rely
heavily
on
third-party
payer
reimbursement
such
as
Medicaid
chip
and
Medicare,
because
of
their
mission
to
serve
the
uninsured.
The
uninsured
are
the
largest
group
served
by
the
health
centers
that
they
account
for
less
than
six
percent
of
their
total
revenues.
The
webinar
will
also
discuss
the
impact
of
Medicaid
eligibility
or
benefit
changes
on
health
centers,
as
well
as
other
issues
facing
health
centers
in
the
coming
years.
A
We
are
very
fortunate
to
have
two
experts
to
another
clone.
Today's
webinar,
the
first
is
dawn
McKinney
with
the
National
Association
of
Community
Health
Center's
and
dr.
Tony
amosa
with
the
community
health
of
South
Florida.
Our
webinar
today
will
conclude
with
a
question
and
answer
session.
Please
note
that
you
will
not
be
identified
when
you
ask
the
questions,
nor
can
other
participants
see
which
you
have
type
just
as
a
quick
reminder.
You
may
participate
by
clicking
on
the
Q&A
buttons
and
at
the
bottom
right
corner
of
your
screen
and
typing
in
your
question.
A
A
So,
first
off
just
to
kind
of
give
you
a
little
quick
overview
snapshot
of
what
on
community
health
centers
do
and
who
they
serve
in
Mississippi,
just
to
start
with
the
basics.
Obviously,
community
health
centers,
a
federally
qualified
health
center,
commonly
referred
to
as
an
FQHC,
is
a
community-based
nonprofit
for
public
organizations
that
provide
services
to
people
who
lack
access,
the
other
healthcare
based
on
a
medically
underserved
area
or
populations.
A
These
are
typically
tried
to
be
placed
in
high-need
areas,
with
the
greatest
barriers
to
care,
because
also
mention
xq
HC
look-alikes,
just
a
quick
definition
for
that
it's
basically,
these
are
the
same
things
as
an
FQHC.
They
made
all
the
same
requirements
that
they
do
not
actually
receive
federal
funding,
so
just
to
kind
of
give
you
an
overview
of
the
structure
of
the
federally
qualified
health
centers
in
the
state.
In
Mississippi,
we
have
21
organizations
that
monitor
and
oversees
the
delivery
sites
for
the
federally
qualified
health
centers.
A
Primarily,
this
is
done
to
the
mississippi
primary
health
care
associations,
and
this
turns
into
about
actual
188
federally
funded
delivery
sites
across
the
state.
In
addition,
when
you
actually
take
into
account
all
of
the
federally
qualified
health
centers
and
its
political
exercise,
we
have
about
208
delivery
sites
total
throughout
the
state.
These
look
alike
sites
will
also
include
things
like
the
rural
health
centers,
the
school-based
health
centers,
and
these
also
include
both
permanent
health
centers,
as
well
as
seasonal.
A
Just
to
give
you
an
idea
about
how
many
people
in
2011
we're
seeing
at
one
of
these
delivery
sites,
it's
about
three
hundred
and
twenty
four
thousand.
This
is
a
big
change
and
compared
to
about
a
hundred
fifty
thousand
that
we're
seeing
about
ten
years
ago.
So
really
the
people
who
are
participating
in
accident
actually
accessing
these
health
centers
has
more
than
doubled
in
the
past
ten
years.
A
So,
basically,
just
to
give
you
a
little
picture
on
who
was
actually
receiving
these
services.
As
stated
before
in
the
introduction,
these
are
primarily
geared
to
serve
and
provide
access
to
the
uninsured,
I'm
Mississippi
in
2011.
Forty-One
percent
of
the
people
who
access
community
health
centers
were
uninsured,
the
others
largest
contributors
were
Medicaid
at
thirty
one
percent
of
Medicare,
as
ten
percent
and
in
other
forms
of
public
and
private
insurance
at
eighteen
percent.
A
So
really,
as
you
can
see
in
Mississippi
about
eighty-two
percent
of
the
people
who
use
these
services
are
either
uninsured
or
in
some
form
of
supplemental
assistance
and
wide
to
be
proud
of.
This
population
go
and
actually
accessing
services
piccoli.
These
are
provided
for
medical
conditions
as
well
as
preventive
services.
In
regards
to
actual
medical
conditions,
they
sought
treatment
for
top
ones,
being
hypertension,
diabetes,
asthma,
depression
and
mood
disorders
and
heart
disease
on
the
preventive
side.
A
A
So
at
this
point,
I'm
very
pleased
to
introduce
our
speakers
dawn
McKinney
serves
as
the
director
of
state
affairs
for
the
National
Association
of
Community
Health
Center's.
She
works
with
the
state
and
regional
Primary
Care
Association
on
their
legislative
and
regulatory
agenda.
Her
main
areas
of
focus
currently
are
the
Affordable
Care
Act
implementation,
including
Medicaid
expansion
and
health
insurance
exchanges
and
payment
reforms.
Her
work
is
focused
on
tracking
health
care
policy
across
the
country
and
identifying
trends
that
impact
health
centers
after
dawn
concludes
speaking,
we
will
hear
from
dr.
A
Tony
I'm
ova,
who
is
the
chief
medical
officer
for
community
health
of
South
Florida,
as
well
as
medical
director
of
the
health
choice,
miss
Network.
He
is
responsible
for
the
oversight
and
direction
of
community
health
of
South
Florida's,
clinical
programs
and
services.
As
the
medical
director
of
the
health
choice
network
network,
dr.
B
Thank
You,
Lonnie
and
good
afternoon.
Everyone
I
appreciate
this
opportunity
to
speak
with
all
of
you
today,
I'm
dharmic,
any
of
the
director
state
affairs
at
the
National
Association
of
Community
Health,
Center's
and
I'm,
going
to
walk
through
a
little
bit
more
in
depth
about
health
centers
and
who
we
are
what
we
do.
We
serve.
B
So,
to
start
with
the
five
basic
characteristics
of
health
centers,
as
Lonnie
mentioned,
health
centers
are
located
in
high-need
areas,
both
urban
and
rural.
It's
actually
roughly
evenly
split,
which
are
medically
underserved.
They
provide
comprehensive
care
which
I
will
describe
in
more
detail
shortly.
They
serve
all
regardless
of
ability
to
pay
and
are
governed
by
community
boards,
which
means
that
we
51%
of
the
board
members
are
patients
of
the
health
center,
making
them
more
responsive
and
accountable
to
the
communities
that
they
serve.
B
Health
centers
are
also
held
districts,
performance
standards
in
terms
of
the
types
of
health
centers
I've.
You
did
here.
Lonnie
talk
about
FQHCs,
which
is
what
we
call
federal
qualified
health
centers
for
short
of
those
are
different
types:
community
health,
centers,
migrant
health,
centers
healthcare
for
the
homeless
and
public
housing.
Fqhc,
look
like
this
on.
You
mentioned,
meet
the
same
requirements,
but
do
not
receive
grant
funding.
B
These
are
just
these
are
the
services
offered
by
health
centers
and
may
vary
slightly
from
health
center
to
health
center,
but
this
is
at
the
core
at
vast
majority
of
health,
centers
provide
all
of
these
services,
so,
as
you
can
see,
health
centers
offer
extensive
services,
not
just
primary
care,
but
mental
health
oral
health
pharmacy
and
much
more
in
particular,
I
think
it's
worth
noting
what
call
centers
provide
in
terms
of
enabling
services
which
makes
them
unique.
They
provide
a
range
of
services,
as
you
can
see,
including
case
management,
transportation,
translations
and
others
again.
B
You
saw
one
state
example
from
lonny
in
Mississippi
about
where
health
centers
revenue
comes
from.
Here's
a
closer
look
at
health
center
revenues
nationally
Medicaid
makes
up
the
largest
percent
on
federal
grants
are
actually
only
sixteen
point.
Five
percent
state
support
falls
into
the
other
grants
and
contracts.
Category.
B
B
This
was
actually
fifteen
percent.
Less
than
ones
were
then
was
reported
in
fiscal
year.
11
due
to
the
economy
and
the
strange
big
budget
state
funding
for
health
centers
has
been
declining
for
four
years
and
fiscal
year.
12
represents
a
seven-year
low
at
a
time
when
the
needs
really
have
continued
to
rise.
Natalie.
B
Health
centers
improve
health
and
consequently
save
money
by
reducing
emergency
room,
youth
and
hospital
admission
and
reducing
health
disparities.
Overall,
patient
costs
are
twenty
four
percent
less
and
save
approximately
24
billion
dollars
a
year.
Health
centers
also
act
as
economic
engines
in
their
communities.
B
The
next
map
shows
you
again
by
state
the
economic
engine
effect
that
health
centers
have
in
their
in
their
state.
This
is
somewhat
outdated,
dated
from
2009,
and
we
are
confident
that
that
obviously
is
increasing
as
health
centers
grow
and
continue
to
to
hire
more
staff
at
serve
more
patients
and
in
terms
of
dollars.
The
next
table.
I
know
it's
a
little
hard
to
read,
but
I
wanted
you
to
be
able
to
see.
Look
at
take
a
quick
look
at
your
state
and
see
what
the
impact
is
of
the
health
centers
in
your
state
nationally.
B
So
I
think
we
all
know
what
the
supreme
court
decided.
The
most
important
today
for
this
discussion
is
that
is
ultimately
that
Medicaid
expansion
is
a
state
option.
Right
now
it
looks
like
24
governors
have
said
yes
to
expanding
Medicaid
and
another
four
or
leaning.
That
way.
Fourteen
have
said
no
another
three
are
leaning
that
way.
Five
have
not
decided
or
commented,
but
of
course,
as
legislators,
you
know
and
are
acutely
aware
that
this
is
only
part
of
the
picture.
In
most
cases,
the
decision
will
actually
come
down
to
the
legislature.
B
In
terms
of
what
legislators
can
do
and
to
support
their
health
centers
continuing
to
provide
state
state
funding
which
can
enable
health
centers
serve
more
uninsured
or
expand,
services,
links
and
hours,
make
capital
improvements
and
strengthen
the
workforce.
They
can
maintain
and
expand
Medicaid
and
CHIP,
which
is
vital
to
health,
centers,
financial
eligibility,
I'm,
sorry,
financial
viability
and
the
main
source
of
coverage
for
patients.
We
serve
strengthen
the
workforce,
meet
the
growing
demand
by
revitalizing
state
health
care,
workforce
programs
and
licensure
laws
supporting
loan
repayment
for
primary
care
providers
working
in
medically
underserved
areas.
B
C
B
C
C
What
I'm
going
to
talk
about
on
in
short
for
some
of
them
in
in
some
in
detail
in
some
of
the
other
ones,
is
to
give
an
overview
of
my
health
center
community
on
the
South
Florida
I
will
share
with
you
a
typical
story
of
a
each
high
patient
and
I'm,
going
to
talk
about
that
value.
That
I
see
health
centers,
playing
the
can't
health
system
and
I
just
abbreviate
as
th
speeds,
by
referring
to
all
the
different
today.
C
The
qualified
healthcare
systems
that
we
have
and
then
I'll
talk
about
perhaps
or
the
new
health
system
holds
for
health
centers
and
what
Medicaid
expansion
I
mean
to
Florida
health
centers,
including
my
own.
What
would
happen
to
my
patients,
with
or
without
Medicaid
expansion,
I'll
share
with
you.
Some
of
the
things
we
doing
in
florida
in
other
health
is
across
the
country
and
positioning
ourselves
for
healthcare
reform
and
perhaps
there's
more
exciting
things.
C
I'm
not
going
to
review
all
of
these
services,
because
I
think
I'm
clearly
underscored
by
the
previous
speakers,
but
just
to
say
that
community
elder
South
Florida,
for
example,
has
to
urgent
care
centers
provided
as
last
year.
Over
10,000
visits
to
patients
may
of
whom
would
have
ended
up
in
a
local
e.
Are
so
we're
very
excited
about
that,
sir.
We
will
divide.
We
have
for
pharmacy.
C
Jenny
said
over
over
100,000
prescriptions
last
year
long
and
we
have
such
an
extensive
behavioral
health
department
with
all
the
usual
bells
and
whistles,
including
a
24-7
16
bed.
Entation
crisis
stabilization
unit.
Instead
of
us,
the
only
CSU
all
the
way
down
spell
that
can
accept
the
classification.
C
It's
so
typical
patient
who
died
received.
All
of
these
services
would
have
come
in
through
our
walk-in
service.
Perhaps
or
are
two
ever
spell
from
another
PCP,
it
could
be
a
mom
schedule
to
see
a
family
practitioner
and
with
a
child.
The
pediatrician
at
the
same
time
take
that
by
a
consultation
services
and
with
your
visit
they
would
they
receive
their
all
discharge.
The
screenings
even
developmentally
depression
screenings
in
most
of
our
main
sites.
C
We
have
both
like
embedded
the
ever
health
consultants
right
in
primary
care
who
the
patient
could
have
seen
if
they
had
a
health
problem
that
was
adversely
impacting
on
their
chronic
disease
or
other
a
nutritionist
medication.
Susan's
wrecker
and
sometimes
even
a
witch
person
who
visited
by
such
a
patient
would
have
to
see
an
appointment
from
a
dentist
for
a
dentists
are
some
extras.
You
would
have
received
medications
from
one
of
our
fantasies
with
significant
before
to
be
enabled
this
live
x
rays
on
on-site
driven
home
by
a
consultation.
C
C
So
another
privilege
of
working
in
a
health
center
right
out
of
internal
medicine
residency
and
I'm
supposed
to
truly
appreciate
what
we're
able
to
offer
to
our
patients
in
the
community
they
serve,
and
so
this
slide
is
outlined
some
of
the
t
ones.
I
think
the
first
two
bullets
on
this
slide
actually
highlight
what
I
think
are
the
most
valuable
one.
C
Imagine
no
most,
if
not
all,
of
the
health
centers
were
born
out
of
a
community
need
to
address
pressing
all
disparities
the
as
a
result
of
this
and
the
regulatory
requirement
for
health
centers
to
perform
theoretical
meeting
these
assessments,
it
has
continued
to
keep
health
centers
grounded
in
this
community
oriented
net.
Another
thing
is
a
very
valuable
rural
health
and
display
hell.
That
was
also
serve
as
medical
homes,
and
we
know
that
the
uninsured
and
medicaid
are
more
likely
to
receive
access
in
health
center.
C
In
fact,
we
learned
that
as
a
result
of
economic
downturn,
the
potential
drop
that
was
expected
with
percentage
of
adults
and
florida
receiving
a
dental
visit
that
was
initially
about
sixty
percent.
We
expected
back
to
drop
to
50
way
less
than
fifty
percent.
It
stayed
there
because
elephant
is
existed
and
they
were
able
to,
and
most
of
them
provide
preventive
dental
services.
So
those
is
very
exciting
for
me
to
learn,
and
it's
exactly
that
in
my
elephant
as
well.
C
Additionally,
health
centers,
having
that
primary
drive
to
integrate
behavioral
health
care
to
primary
health
care
on
something
that
happens
in
two
types
of
life.
Florida
health
centers,
has
been
a
big
value
and
then,
as
was
mentioned,
my
previous,
because
a
whole
array
of
enabling
supports
davis's,
make
health
understand
our
community,
sir,
but
I'll
titles,
even
all
of
that
health
and
quality.
C
There
is
this
the
number
of
very
good
business
reasons
for
existence
of
Cal,
centered
and
under-resourced
communities
editor,
and
we
need
to
take
a
look
at
how
the
country
we
know
that
health
centers
provide
temptation
costs
and
only
than
a
comparatively
less
than
the
other
health
settings
in
Florida.
In
one
study
that
we
looked
at,
it
says
that
Florida
health
centers
cared
for
12,
defend
of
middle
of
the
Medicaid
population.
However
their
Medicaid
payments
I
come
to
for
about
one
percent
of
medicaid
ambulatory
care
spending.
I
think
that's!
You
know
spending
where
you'll
note.
C
The
ability
of
health
centers
will
also
provide
employment
and
communities
is
also
very
easy.
Indeed,
my
health
center
alone.
We
provide
job
opportunities
for
over
600
people
and
we
talking
about
mothers
and
fathers
and
daughters
and
sons
who
would
otherwise
avoid
in
other
counties
or
other
states.
Perhaps
if
the
health
center
doesn't
exist,
in
fact,
L
centers
in
low
areas
are
often
among
the
largest
employers,
I
mean
if
survival
really
drives
the
survival
of
that
that
those
communities
I
last
dawn,
shed
least
arm
in
a
slide
87
million
in
business.
C
This
is
in
Florida
alone,
generated
in
challenge
neighborhoods
in
my
health
center.
Our
economic
analysis
showed
that
it
was
a
budget
of
budget
about
45
million
and
in
economic
activity.
We
generated
including
construction
work,
food
and
cleaning
services,
banking,
all
that
another,
almost
50
million,
almost
many
four
million
in
a
kind
of
like
activity.
That's
from
my
health
went
alone,
and
I
think
that's
that's
pretty
neat.
C
Sorry
I'm
Medicaid
is
the
single
largest
source
of
revenue
for
health
centers
in
Shimoda
over
a
third
of
total
sq
see
revenues,
a
significant
and
state
of
local
grants
make
up.
Only
thirteen
percent
I
really
wish
will
be
way
more
than
that.
But
in
addition,
the
revenue
stream
Medicaid
expansion
would
provide
to
a
health
centers
across
the
state
in
the
country.
I'm.
Quite
pleased
about
the
fact
that
there
were
the
expenses
and
coverage
for
things
that
are
quite
important
up
front
and
then
downhill
preventive
health
services
and.
C
I
put
in
there
something
as
seemingly
little
as
smoking,
cessation,
pregnant
women
and
their
lives
that
would
it
was
saved
by
the
provision
of
this
average,
so
I'm
going
to
talk
about
what
would
happen
to
my
citations
with
or
without
Medicaid
expansion.
Just
underscoring
the
fact
that
health,
and
it
would
always
be
there
I'm,
hoping
that
other
state
and
local
governments
will
help
to
make
us
more
and
more
successful
regardless
or
what
happens
at
the
federal
level.
But
whether
you
mentioned
know
the
fact
that
there
would
be
some
pros
and
cons.
C
Obviously
and
I
put
out
this
visual
slide
to
just
represent
a
summary
of
how
I
see
it
with
my
patient
in
our
communities.
Our
stations
come
from
of
what
could
happen
directly
indirectly.
So
do
I
click
through
my
health
center?
You
know
either
our
clinical
physical
operational
activities
in
terms
of
access
to
care,
preventive
care
care
outcomes,
workforce
by
ability
and
differentiate
of
activity,
as
well
as
indirectly,
on
the
health
care
in
economic
activity
out
there.
How
many
sees
my
patients
come
from
so
just
be
a
good
visual.
C
That
would
then
lead
into
my
next
slide,
which
is
clinical
all
right.
What
would
happen
to
my
nation?
We
know
that,
yes,
with
medical
expansion,
hopefully
they'll
be
improve
access
to
care
for
it
for
newly
eligible
and
better
care
outcomes,
your
residents
would
lose
their
health
insurance,
more
health,
mental
health
patients,
homeless
patients,
low-income
tech
transfer
coverage.
C
Yes,
we
do
expect
that
waiting
list
might
get
longer
and
as
populations
increase
in
terms
of
wrestling
that
lose
health
insurance
and
lose
that
job
health
centers
will
be.
There
continue
be
that
medical
home
and
the
last
one,
because
last
week,
I
saw
a
patient,
a
young
woman
who
would
love
with
jobless
insurance
and
the
PCP
their
fabric
panel.
C
C
One
I
thought
it
was
very
interesting.
It
talks
about
this
then
you're.
Talking
about
the
fact
that
operationally
Medicaid
expansion
has
this
benefit
of
reducing
the
illustrative
breading
of
having
to
verify
the
ever-changing
insurances,
and
she
was
saying
that
she
should
expect
that's
going
to
be
a
possibility
for
her,
because
it
spent
a
lot
of
time
doing
this.
Okay,
interesting.
So
that's
something
that
we
cut
excited
about.
The
Medicaid
expense
will
provide
obviously
without
Medicaid
expansion.
C
Indirectly,
how
Medicaid
expansion
would
will
have
some
effect
on
anything
I'll
just
share
with
you
my
opinion
about
some
of
those
in
my
health
center
and
definitely
the
community
that
we
provide
to
assist.
Do
I
do
expect
that,
in
terms
of
health
care,
certainly
with
Medicaid
expansion,
CGR
dogs
will
be
less
likely
to
move
to
other
states,
in
fact
interesting
as
I
sortation
a
new
year
month
ago.
I
remember
this.
C
Clearly,
this
patient
moved
from
California
to
Florida
and
came
in
to
see
as
my
health
center
it
most
because
he
thought
that
he
was
going
to
be
more
likely
to
obtain
Medicaid
and
in
eventually
realized
that
it
was
no
easier
later
on
Kate.
She
received
surgery
until
he
does
decided
to
move
back
and
total
to
link
them
up
another
health
center
on
the
other
side
and
send
all
the
destination
and
stuff
like
that.
But
it
made
me
appreciate
that
this
was
actually
real.
C
You
know
how
sad
we
can
try
to
have
camera
almost
in
every
issue
until
exists,
but
the
interesting
thing
was
she
said
about
a
month
before
she
came.
They
run
over
out
of
her
medications
or
blackish
I
hit
like
1
60
systolic,
which
is
no
medium
high
and
she
went
to
the
ER
and
I
thought
wow.
We
have
an
education
center
here.
If
she
had
come
in
to
see
you
know
just
seeking
hair
here,
she
would
normally
service.
C
So
while
there's
an
opportunity
for
health
and
as
I
aggressively
educate
on
these
services,
I
realized
that
my
house
center.
We
continue
to
aggressively
educate
on
the
edge
in
care
centers
we
have
and
how
they
can
prevent
ER
visits
with
all
that
Medicaid
expansion,
the
economic
activity,
impactful
Medicaid
expansion
is
also
real.
I
have
a
seat.
Patients
who
have
to
borrow
money
to
pay
for
health
care
needs,
especially
hospital
care
and
patient.
C
Who
will
have
to
worry
about
limiting
how
much
ways
they
do,
because
if
there
were
two,
must
make
more
money
to
lose
their
Medicaid
and
one
hears
these
star
is
just
incredible
in
the
trenches,
and
so
at
least
I
am
excited
that
I'm
there
with
my
Center
and
clinicians,
and
that
seems
to
provide
services
to
all
these
patients,
regardless
of
what
the
circumstances
are
meeting
the
needs.
The
best
we
can.
C
So
I
think,
regardless
of
what
happens
to
Medicaid
in
all
the
state
or
the
country,
health
centers
will
be
there
to
help
cushion
the
impact,
unless
of
obviously
states
also
decide
to
cut
this
name
to
help
them
to
significantly.
Now
that
would
be
a
change.
I
would
think,
and
we
hope
that
I'm
back
or
you
know,
all
of
that
is
supporting
the
safety
net
will
exist
to
help
to
make
sure
that
between
federal
state,
local
private
funding
that
health
centers
will
exist.
C
So
with
all
of
this
going
on
health
centers,
obviously
strategically
position
is
positioning
themselves
to
success,
regardless
of
the
direction
of
health
care
for
Medicaid
expansion
and
funding,
and
so
on
and
very
important
for
us
as
continuity
of
care.
Developing
alliances
either
let
other
little
house-
local
health
care
providers,
spitting
in
health
information
exchange
to
make
sure
that
this
is
meet
information
sharing,
seamlessly.
C
Medicaid
and
Medicare
and
all
the
other
side
exist
right
now,
but
also
that
are
counting
called
enabling
sensitive
services.
We
provide
transportation
and
translation
and
and
and
so
on
and
so
forth.
We
all
actually
I'm
doing
better
with
that.
So
we
can
demonstrate
that
added
value
and
we
also
learning
the
value
of
the
coming
part
of
health
center,
controlled,
Network
and
utilizing
economies
of
scale
to
improve
outcomes
and
all
of
that
of
anything
I'm
quite
excited
about
the
rural
health
Henderson,
cleaner
and
the
new
health
care
system.
C
I
am
so
I
feel
so
privileged
and
I
have
my
condition
see
the
same.
We
hear
that
from
health
under
the
other
country
that
the
healthiness
has
a
big
role.
I
think
everybody
most
people
really
appreciate
that,
but
as
medical
homes,
especially
with
our
abilities
to
ramp
up
with
relative
speed
and
a
commitment
to
all
their
labeling
programs,
that
we
know
make
it
different,
I
think
what
some
rolls
all
countries
of
by
providing
the
best
opportunities
to
reduce
health
disparities
in
their
areas
of
most
need.
C
We
also
know
that
the
young
hospitals
and
medical
school
settings
our
residency
training
settings
how
far
this
perhaps
present
one
of
the
best
training
grounds
for
clinicians,
and
so
we
see
the
alpinist
being
a
huge
role
there
and
excited
bad
health
care
reform,
with
facilitating
health
centers
setting
up
setting
up
to
become
teaching
health
centers
wi
direction.
I
also
see
health
centers
presenting
an
interesting
role
as
research
institutions.
Traditionally,
minorities
are
not
included
in
lots
of
clinical
trial
and
so
newer
medications,
and/or
devices
and
don't
get
to
be
tested
enough
in
minorities
and
I.
C
I
was
quite
excited
to
see
that
our
Florida
State
Legislature
through
a
lot
of
work
and
lobbying
and
hard
work
we're
able
to
allow
Medicaid
payments
for
multiple
visits
in
the
same
day
in
for
the
health
center,
so
that
the
patient
comes
to
see
me
for
primary
care
can
see
that
a
cactus
and
pants
get
they
can
see
the
high
specialist
and
before
they
leave.
Because
again
we
want
to
make
sure
we
don't
use
every
opportunity
to
provide
a
des
fêtes
flotation
I
want
to
end
up
with
some.
C
C
Now
you
project
that
to
potential
Medicaid
recipients
across
the
u.s..
That
is
huge
and
when
you
look
at
the
fact
that
health
centers
take
care
off,
and
on
said
one
and
other
low-income,
uninsured,
almost
all
of
whom
well
then
have
Medicaid
I
think
that
vacation
is
bad
health
and
it
will
save
thousands
of
lives.
That
was
a
us
every
week
with
with
Medicaid
expansion.
Secondly,
and
I
think
that
it
is,
you
know,
if
that's
what
it's
all
about-
it's
all.
C
I
think
it
all
balls,
understated,
lives
and
I'm
very
excited
that
health
centers
are
able
to
be
to
be
a
false
front
in
this
aspect
and
as
the
slide
indicates
that
fanatical
publish
new
england
journal
in
2012,
you
look
across
between
7,500
to
12,000
and
each
other
regions.
Life
would
be
saving,
maybe
expansion,
and
I
think
that
with
or
without
that
health
centers
will
be
there
to
be
a
part
of
this
effort.
As
the
position
ourselves
is
better
span
the
communities
that
we
work
in
in
the
new
health
care
system.
Thank
you
very
much.
A
Thank
you
so
much
gone
internal
for
those
wonderful
presentations.
Now,
there's
a
doctor
open
the
floor
for
participer
ticipate
questions
and
answers.
Melissa
Melissa,
Hanson
I'm
in
cfl
will
be
helping
write
the
questions
to
the
panelists
as
a
quick
reminder
to
ask
a
question
quick
to
make
I
type
in
your
question
in
the
box
below.
Please
make
sure
you
ask
your
question
to
all
panelists
and
remember
that
the
questions
will
remain
silent.
D
B
D
C
D
Great
thank
you.
This
is
a
question
may
be
directed
at
both
Tony
and
Lonnie.
Our
health
center
is
prepared
to
support
child
results.
Do
they
have
the
sort
of
infrastructure
to
do
that
and
our
state's
and
money
this
might
be
directed
to
our
state's
looking
looking
at
community
health.
Centers
is
sort
of
part
of
the
safety
net.
C
C
Okay,
yeah,
all
of
us
in
terms
of
strategically
planning
to
help
position
ourselves
for
health
care
reform
and
Medicaid
expansion
are
looking
at
that
an
influx
of
patients.
You
know
anyone
faces
of
all
ages,
especially
yes,
shall
there's
a
dog
and
looking
at
capacity
building
with
additional
sites,
there's
no
staffing
additional
resources.
So,
yes,
I,
think,
there's
a
lot
of
effort
in
the
ground
level
across
the
country,
either
starting
to
do
that
or
or
looking
for
support
to
do
exactly
that
in
terms
of
safety
net.
D
B
Something
that
you
know
as
part
as
part
of
the
health
center
costs
and
we
federal
funding
for
through
this
330
can
be
used
and
it's
part
of
their
cost.
But
in
some
cases,
are
in
some
cases
some
services
may
be
reimbursed
by
Medicaid
as
well.
It's
a
very
from
state
to
state,
but
and
in
some
cases
that
you
know,
depending
on
the
services
they
may,
a
health
under
might
seek,
grant
or
state
of
local
supports
/
to
support
specific
services
as
well.
D
B
The
Bureau
of
primary
health
care
has
a
pulse,
enter
locator
on
their
website.
I
think
you
can
put
in
your
zip
code
and
and
see.
We
also
have
information
on
the
neck
website,
www
org,
about
where
health
centers
are
located
across
the
country
and
you'll
find
resources
there
as
well
about
on
both
the
bureau's
website
and
next
website
about
how
health
centers
are
located
in
medically
underserved
areas.
It
is
actually
a
somewhat
complex
system
in
terms
of
I
comes
down
to
socio-economic
information,
as
well
as
the
number
of
providers
in
any
given
area.
B
So
it's
unfortunate,
that's
something.
I
can
just
explain
in
a
sound
bite,
but
there's
a
lot,
some
formation
available
about
how
that
is
formulated
and
if
there's
a
community
like
the
Eastern
Shore,
where
there's
may
not
be
adequate
access
to
health
centers,
a
community
can
seek
health
center
funding
from
the
federal
government
to
get
started
and
would
encourage
them
to
take
a
look
at
that
process,
and
we
have
information
on
our
website
again
about
how
to
go
about
that.
C
Right,
thank
you
for
the
question
all
right,
so
health
centers
I
replied
to
have
them
services
accessible
to
their
patient,
which
means
that
you
either
provide
that
directly
or
you
provide
that
endure.
You
have
a
local
resource
that
provides
that,
by
with
a
clear
written
agreement
for
what
services
will
provide
you,
a
patient
at
the
minimum,
preventive
dental
services,
and
so
that's
that's.
What
has
this
position
is
in
fact
to
be
to
be
eligible
at
the
federally
qualified
health
and
all
that
community
health
center.
You
must
have
an
array
of
service
that
you
provide
directly.
C
D
Thank
you,
I
think
this
will
be
our
last
question
of
the
webinar,
and
this
is
directed
at
both
Tony
and
Don.
Can
you
talk
a
little
bit
about
turn
and
ways
that
face
and
turn
being
sort
of
people
moving
between
Medicaid
and
the
exchange
once
those
are
operational
about
what
health
centers
are
doing
to
prepare
for
that
or
how
they
can
help
space
with
that
Don?
Do
you
want
to
start.
C
Correct
in
my
family
did
exactly
that
that
I,
daunted,
the
quantum
of
things
and
health
Enders
in
the
states,
are
doing
I
mean
that
obviously
includes
making
sure
that
we,
we
present
the
best
opportunity
to
be
medical
homes
rotation.
So,
regardless
of
that,
you
know
that
Shannon's
plans,
a
part
of
for
the
very
exchange
that
we
just
provide
service
for
all
of
those
and
I
think
help
them
as
I
was
broken
into
health
information,
exchanges
and
dams
of
anticipation.
C
Those
as
well
as
also
being
their
aggressive
in
the
development
off
and
involvement
in
the
development
of
health
information
exchange,
making
sure
that
we
part
of
their
discussions
of
the
solutions
to
exchanging
information
across
so
that,
even
if
stations,
change
providers
move
move
to
the
stage
we
get
to
a
point
where
we
we
can
actually
easily
obtain
the
patient's
health
information
or
also
submit
to
the
way
by
the
date.
They
need
it
to
be.
To
help
maintain
continuity
of
care.
D
A
Okay,
once
again,
I
would
just
like
to
thank
both
of
our
speakers,
dawn
and
Tony
for
taking
the
time
out
to
do
this
webinar.
This
will
conclude
the
webinar
and
once
again,
I'd
also
like
to
thank
all
the
attendees
for
your
time
and
participation
in
today's
conference
and
I
hope
you
all
have
a
one
food.