Healthcare Industry

The Number of Insured Americans is Dropping: What This Means for FQHCs

A New Report on Number of Uninsured

A recently published U.S. Census Bureau report found that the number of Americans without health insurance has risen for the first time in a decade. 8.5 percent of the U.S. population went without medical insurance for all of 2018, up from 7.9 percent in 2017 – the first year-over-year increase since 2008-09. According to the report, most of the drop in health coverage was related to a 0.7 percent decline in Medicaid participants. Experts attribute this decline at least in part to the current administration’s efforts to curb immigration, including the new public charge rule that would penalize those applying for citizenship or legal U.S. residency for their use of public assistance programs like Medicaid. Other experts point to cuts in outreach programs that educate consumers about their health care options, as well as the elimination of the Affordable Care Act’s (ACA) tax penalty for people who don’t have health coverage, as reasons for the overall decline in the number of insured.

The Consequences for FQHCs and Those They Serve

Discouraging the use of public benefits like Medicaid adds to the continued challenges of underserved populations in accessing healthcare. Many people may be more hesitant to seek medical care, either because they are unable to pay or for fear of the public charge rule. Lack of quality care – especially preventative care – can lead to overuse of the ER, which drives up costs across the board. Longer term, this trend has serious public health consequences. Lack of access to care can lead to delayed diagnoses, higher rates of chronic conditions and worse health outcomes. For children, the impact is especially significant, with health issues linked to school absenteeism, lower grades and decreased likelihood of graduating from high school.

As key safety net facilities for underserved patients across the country, federally qualified health centers (FQHCs) are on the front lines of this issue. One in 12 Americans receive their care from an FQHC. Higher numbers of uninsured patients mean lower reimbursements from Medicaid and private insurers, putting the financial stability of these centers in jeopardy at the very moment when the volume of underserved patients is likely to increase. There is a direct connection between Medicaid expansion and the financial viability of FQHCs – as well as their ability to drive favorable care outcomes. A recent study showed that FQHCs in states that have opted into Medicaid expansion offer better patient care access, behavioral health access and community care than those in non-expansion states. The study also showed that expansion state FQHCs were more likely to operate under some type of value-based care model, an important step in decreasing the cost of healthcare and improving access for everyone.

How We Can Help

At CareMessage, we understand the pressures that FQHCs face in keeping costs down while maintaining a high standard of care. We can help you develop a cost-effective patient engagement strategy that addresses the four driving factors in health outcomes: patient satisfaction, patient recruitment, disease prevention and avoidable readmissions. For more information on the financial benefits of patient engagement and how our technology platform can help, please enter your information below and we'll be in touch.

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