Montana’s best value in community health

Billings Gazette Editorial

by Billings Gazette

Last year, RiverStone Health logged 75,679 patient visits – 3,855 more than in 2010.

Over that five-year period, the community health center with clinics in Billings, Worden, Joliet and Bridger documented these healthy changes:

• The percentage of RiverStone patients getting recommended screening tests for cervical cancer increased from 34 to 53.

• The percentage of its 3-year-old patients who have all recommended vaccinations increased from 66 to 69.

• The percentage of diabetic patients whose illness was controlled increased from 44 to 53.

• The number of family medicine residents in training increased from 18 to 24.

• Eleven staff physicians, dentists and physician assistants were recruited with incentives of scholarships or loan repayment through the National Health Service Corps.

About half of the 17,000 patients RiverStone treated last year had no insurance and many of the rest are low-income Montanans who cannot afford to pay the out-of-pocket-costs required by their high-deductible health plans. These people still get needed medical, dental and behavioral health care at RiverStone on a sliding fee scale based on their income. Those fee subsidies totaled $3.7 million in 2014 — $750,000 more than in 2010.

The Affordable Care Act is the reason why RiverStone was able to provide more treatment, improve their patients’ health, train more doctors, recruit professional staff and subsidize more care for low-income Montanans since 2011.

The provisions of the ACA that boosted community health centers across America sunset when the federal fiscal year ends on Sept. 30. Unless Congress renews this primary care funding, 1,300 nonprofit community health centers nationwide, including 16 in Montana, will no longer have the resources to serve all of the uninsured and underinsured patients.

When queried by a Gazette reporter last week, Sen. Jon Tester, D-Mont., said he supports reauthorization of the Community Health Center Trust Fund the ACA established.

He knows that CHCs deliver primary care efficiently and are particularly well-equipped to meet the needs of low-income folks. For example, RiverStone provides MET bus passes or cab fares to patients who don’t have any other transportation to the clinic.

Asked if Rep. Ryan Zinke, R-Mont., would vote to reauthorize the trust fund, his spokeswoman said there isn’t a bill yet and Zinke would have to see the bill first, but he supports community health center funding generally.

Sen. Steve Daines, R-Mont., didn’t express support or opposition to reauthorizing the CHC Trust Fund.

Montana needs all three members of our delegation to prevent a loss of funding for the Community Health Centers where 95,000 of us get our health care.

The expiring trust fund provides a substantial portion of the budget for these centers. At RiverStone, for example, the funding at risk equals about 20 percent of the clinic’s budget.

The Congressional delegation should remember that nearly 70 percent of the doctors trained in Billings over the years are still practicing in Montana. Furthermore, Community Health Centers would be at a competitive disadvantage if they lose National Health Service Corps loan repayment incentives. They can’t afford to pay the salaries that other organizations can.

These local clinics provide tremendous value for the public dollar.

“On a per patient, per year basis, Community Health Centers cost less than typical primary care,” said John Felton, RiverStone CEO. “Patients who enter community health systems tend to have uncontrolled, chronic health problems, but the health centers usually get them under control.”

Community Health Centers have received strong bipartisan support since the first were established in 1965. Montana needs its entire delegation to advocate for reauthorizing Community Health Center Trust funding.