04/16/2012
FORUM: Community health centers fill medical needs
Rapid City Journal features Op-Ed from Tim Trithart of the Community Health Center of the Black Hills
Simply being insured by Medicaid in South Dakota isn't always enough to get the health care you need; you also have to find a doctor or dentist willing to accept it as payment. For more and more doctors in our state, Medicaid's reduced reimbursed rates make it harder and harder to justify doing just that.
Take the story of Chris, a typical 14-year-old boy from Spearfish. A few months ago, he was playing basketball when he was hit square in the mouth, knocking out a front tooth. His frantic mother called around to several nearby dental clinics for help. But she couldn't find one who would see him because they weren't accepting new Medicaid patients. So she brought him to the Community Health Center of the Black Hills.
Unfortunately, Chris' story isn't unusual. We see a lot of hard-working individuals in our region who struggle to find affordable care. Some are covered by Medicaid but can't find a doctor accepting new patients. Some are uninsured. And some have private insurance, only with deductibles so high they end up paying full price out of pocket for nearly everything.
At the Community Health Center, we see everyone — regardless of how much they make or what their insurance. For close to 14,000 people in the Black Hills, we are their medical home.
For instance, Dr. John Lassegard, a board-certified family practice physician and our current medical director, has some patients in his patient panel that he's been seeing regularly for more than 15 years. We have about a dozen providers who work for us. The average provider's been with us for about four years, sees thousands of patients a year, orders labs and X-rays, and has his or her quality monitored on an ongoing basis.
In short, we're just like any other clinic. The only difference is what we charge a patient may be discounted based on how much money he or she makes. Close to 7,000 of our patients qualify and pay for their health care out of their own pocket, at a discounted rate. Nearly a third are below the federal poverty line — making just $11,170 annually — and qualify for our largest discount.
Community health centers like ours ensure that people like Chris aren't forced to put off basic preventive health care because they can't afford it. When people put off routine health care, they often just get sicker. Patients end up turning for care in the emergency room or end up hospitalized later on. And that just drives up the cost for health care for all of us.
While the Affordable Care Act increases the number of people eligible for Medicaid by 2014, it will do little good if reimbursement rates are so low, doctors refuse to accept it. When other clinics can't afford more Medicaid patients (let alone the uninsured), the pressure on community health centers to fill that gap for basic primary care only increases.
Over the years, we've expanded to multiple clinics at multiple sites to meet growing demand. With the increase in Medicaid eligibility, we're expecting even more need.
We recently purchased land with the plan to build a new, larger, consolidated clinic so we can better serve our patients and add even more providers to our team. To make this a reality will require a great deal of community support and an understanding of the positive impact a community health center makes — both economically and health-wise.
The bottom line is this: As a community, we need to ensure that adults and kids like Chris have access to basic health care. We can't afford to do this with hospital-based care or at emergency-room prices. We need to ensure that basic primary medical and dental care is affordable and accessible for everyone. And that's what community health centers like ours are all about.
