Boston Globe, Sept. 28, 2007
By Robert Preer, Globe Correspondent | September 27, 2007
At Lynn Community Health Center, about 1,700 people a month have signed up for the new state health insurance program this year. North Shore Community Health Center reports an 8 percent increase in patients due to enrollment in the state program. The Cambridge Health Alliance’s new center in Malden has treated more than 3,000 patients since it opened two months ago.
“I have seen significant growth in the number of patients coming to our community-based centers in the past year,” said Randy Wertheimer, chairwoman of the family medicine department at Cambridge Health Alliance, which also has a center in Revere. “I feel we’ve not seen the bottom of this at all.”
The state’s universal health insurance law, which is being rolled out this year, is bringing the previously uninsured into the healthcare system.
Many of the newly insured are turning to community health centers, the locally based, nonprofit organizations that arose from the antipoverty movement of the 1960s.
Most of the centers have outreach programs to assist people in filling out forms and selecting plans. After they sign up, many individuals and families seek care at the centers.
“In the urgent-care department, we are clearly seeing new people,” said Tom Sterne, medical director of the Massachusetts General Hospital Chelsea Health Care Center and a family-care doctor. “People who have new access through insurance are taking advantage of it.”
Statewide, patient loads at community health centers have been on the rise, even before the universal coverage law went into effect this year. Last year, centers in Massachusetts saw 760,301 patients, an increase of nearly 94,000, or 14 percent, over the previous year.
“We are front and center in the new healthcare legislation,” said Kerin O’Toole, spokeswoman for the Massachusetts League of Community Health Centers. “We’ve seen quite a surge in demand. Although in many cases patients could go elsewhere, the health centers offer a whole range of services you can’t get from a private provider.”
Administrators of community health centers north of Boston say that because the state program is new, it is hard to determine whether it will mean a big, long-term change in the number of people seeking care.
“We are a large clinic. It’s hard to say how many of the people we’ve enrolled would be coming to see us anyway,” said Lori Berry, executive director of the Lynn center.
“It’s too early to know about the numerical impact,” Sterne said. “Clearly there has been some.”
The nation’s first community health center opened at Columbia Point in Dorchester in 1965 as part of President Lyndon B. Johnson’s War on Poverty. Similar centers, supported by federal aid and private grants, opened across the country in poor and medically underserved areas. Today, the United States has more than a thousand centers, 52 of them in Massachusetts. The centers have long been a safety net in the healthcare system, places where people could go whether they have insurance or not. The insured usually have many choices when seeking care.
Patients go to community health centers for a variety of reasons. The facilities offer one-stop shopping, which can include dental care, substance abuse treatment, pediatric and prenatal care, and social services. Most have translators on-site for non-English speakers, as well as child care. Another reason that community health centers are seeing more patients is that three of the four insurers working with the state program, Commonwealth Care, tend to direct subscribers to the centers, according to Alan Sager, director of the health reform program at the Boston University School of Public Health.
Sager said he is concerned that some community health centers may not be able to hire physicians quickly enough to meet the demand. “If health centers were deluged by dozens more patients every day, how quickly could they respond?”
A Massachusetts Medical Society report issued this year warned of a growing shortage of primary-care physicians and some specialists, based on surveys of doctors and Massachusetts residents. “The community health centers rely heavily on primary-care physicians, and if there is a shortage in the state, the centers would be exposed to that shortage,” said B. Dale Magee, president of the Massachusetts Medical Society.
Directors of centers north of Boston say that recruiting is not easy, but they have been able to hire qualified doctors and nurses, and otherwise meet the demands of new patients.
Robert Henderschott, chief executive officer of North Shore Community Health Center, said recruiting is a challenge, but the institution has been able to find staff for its existing facilities in Peabody and Salem and another that is to open later this year in Gloucester.
“Demand has increased but it is not at a saturation point,” Henderschott said.
Sterne said the biggest constraint on the Chelsea center is physical space. “Space limits the size of our staff. We are now at a stage where we’re rehabilitating every last square inch of space in the main building.”
Community health centers have been expanding in Massachusetts and across the country for several years. In 2002, President Bush identified community health centers as key players in dealing with the problem of the uninsured, and he proposed adding or expanding 1,200 centers nationwide and doubling the number of patients treated by community health centers.
Robert Preer can be reached at email@example.com.