Federal government pushes community health centers to provide virtual health services beyond pandemic


The Biden administration is making a new push for telehealth and other digital disease surveillance tools to become sustainable beyond the pandemic.

The U.S. Department of Health and Human Services announced Monday that it is providing nearly $55 million to improve access to community health centers that have played a vital role in patient care as the country grapples to Covid-19.

The new funding is intended to help 29 federally licensed health centers provide better access to telehealth, expand digital disease surveillance and improve health information technologies to make these centers more accessible. .

“We have learned, especially with Covid, that our healthcare system has holes and unfortunately people are falling through those holes. And no one wants to be left behind,” HHS Secretary Xavier Becerra told CNN on Monday.

He called federally licensed community health centers a “game-changing” solution to fill those gaps.

“We’re going to help them focus on virtual care, which we’ve learned throughout the pandemic is also a vital way to reach people who are often missed,” he said.

Barriers to virtual care have been temporarily removed as Covid-19 is a public health emergency, but some centers fear the innovation will die out.

“We share the angst because we are going to need the authority of Congress to be able to continue some of these telehealth opportunities that are available right now … but disappear once we no longer declare it to be ‘a public health emergency,’ Becerra mentioned.

There are bills pending at the federal level that would remove some of the barriers to telehealth. At the state level, there have been at least 37 states that have permanently incorporated telehealth flexibility into state law, according to the National Conference of State Legislatures.

This is not the first federal government initiative to advance digital health. In August, HHS announced 36 awards of $19 million to expand telehealth nationwide, calling it a “vital tool for improving health equity.” In January, the federal government asked the public for input on how digital technology is being used and could transform the way people get health care.

“Nonprofits have a hard time getting into some of the new technologies if they don’t have the kind of money to make those kinds of investments. So this money is going to help them move faster and stay longer and more sustainably in…virtual care,” Becerra said Monday.

The money can’t come soon enough for clinics such as the South Central Family Health Center in Los Angeles, which is among the groups receiving the $55 million announced on Monday.

South Central, like many centers across the country, could not offer virtual care before the pandemic because health centers were not reimbursed for these appointments.

When that changed during the pandemic, it made a difference for patients who might otherwise have to forgo care, according to David Roman, the center’s director of development. He described a patient who found herself struggling with depression and anxiety during the pandemic. She wanted to get help and even make an appointment with the center’s behavioral health team, but kept missing appointments. When the team reached out to find out why, she confessed that while she needed help, she couldn’t afford to take the day off for the appointment.

“A day off could mean not being able to feed your family that week,” Roman said. Since the center was able to schedule her virtual appointments for her lunch hour, she hasn’t missed one yet.

Roman said his health center will use the new funding to figure out how to provide the best virtual care.

“It will also help us learn how to apply different types of technology to help our patients,” Roman said. For example, he said the clinic treats nearly 4,200 patients with diabetes. After transportation and medication adherence, the next biggest challenge is communicating with their providers. This money will help the center provide remote monitoring devices to some of these patients so providers can help control their diabetes.

“This is a technology available to the general public who have insurance that will cover it, but a lot of our patients are uninsured,” said Roman – about 40% of patients at the center. “It’s something that will dramatically improve the kind of care we can provide.”

The 1,400 community health centers supported by the United States federal government serve as a safety net for approximately 29 million underinsured or uninsured patients who live in rural and urban areas with high concentrations of poverty. Many patients at these centers have multiple underlying health conditions and the centers act as their only access to primary care. The centers also offer pharmacy services, mental health care, addiction programs and dentistry.

They provided 19.2 million Covid-19 vaccines and two out of three of them went to hard-to-reach members in communities of color, according to the National Association of Community Health Centers. The centers have also been a major source of Covid-19 testing, according to the Kaiser Family Foundation.

Their efforts during the pandemic have paid off. In areas where there is an active community health center, there have been fewer Covid-19 deaths and infections, according to an analysis by the Morehouse School of Medicine and the National Association of Community Health Centers.

The U.S. bailout gave those health centers an additional $7.3 billion to provide pandemic care, HHS said. The centers, however, have been chronically underfunded and were hit even harder last year with the sharp rise in inflation. Federal government payment models are based on a fixed amount per patient and do not take into account inflation.

When there is funding, community health centers can do more. When virtual tours were reimbursed, the number of community centers offering them increased by 132%. Before the pandemic, 592 centers offered virtual care, in 2022 it was 1,362, according to Health and Human Services. Virtual visits have increased by 6,000% during the pandemic, according to HHS.

Another recipient of the new funding, the Community Health Center in Middletown, Connecticut, which has centers across the state, will use the money to better understand how to use virtual appointments with patients with health issues. behavioral health and medical appointments, said Mark Masselli, the center. founder and CEO.

“The community we serve is cost conscious. You work at 7/11 and the thought of taking two buses to go and waiting half an hour to be seen for 15 minutes is daunting,” Masselli said. “What if they could just make the appointment from their car at lunch instead. I think outside of the pandemic, we’re trying to figure out what this new delivery system will be like.

“Sometimes people feel lost and abandoned between appointments and we think this could be a good tool,” Masselli said.

The center also hopes to expand the virtual care model of school health centers. “You just can’t have a child psychiatrist in every school,” Masselli said. “They have to find ways that will be the force multiplier to do that.”

The center will also use the money to train the next generation of providers on how to integrate telehealth into their practice.

“We’re excited for whatever we can do with this,” Masselli said.

Maria J. Book