Thursday, February 18, 2010

Your Piece of the Health Care Pie: How much would you pay?

This post is re-purposed from Erie Family Health Center's Beats per Minute blog, with permission.


Would you pay $1.94 per day in health insurance for the privilege of unlimited access to comprehensive preventive and primary care services at the level of quality provided by Erie Family Health Center? It sounds like a pretty good deal.

Health care reform pie is on a lifeline in Washington, DC, and cost is of high concern. Meanwhile, around the country, at over 1,200 health centers like Erie, data staff hit the send button this week and uploaded information for 2009 on the 20 million medically disadvantaged people cared for at community health centers. The fix is in, and the data show that health centers provide very cost effective primary care and preventive services.

I’d like to show some of Erie’s results as example. (read more)


Over 33,000 patients now access primary care services at Erie. Perhaps an indication of our economic times, the number is up 10% from a year ago. And patient visits climbed accordingly, to 142,000 in 2009, up 7% in 2009 from 2008.

Our annual report to the feds allows us to calculate the average cost to provide a year of health center services to an Erie patient: $700 per year, or $59 per month, or $1.94 per day. This includes unlimited doctor visits, laboratory services, counseling, case management, oral health care, delivering your baby, 24/7 answering service and coordination of care with our hospital partners. Erie competes for federal grant dollars to help support the 34% of our patients who are uninsured. The annual cost to the feds per uninsured Erie patient is $360 – less than a dollar a day.

If you like a bargain, you are thinking – good deal!

A recent report by Lo Sasso and Bryck in the journal Health Affairs predicted that for every $500,000 additional funds a health center receives, 540 additional patients can be served -- $925 per patient per year, $2.50 per day. Erie is doing better than the national average.

But health the health care pie is really divided into three slices. The first slice is primary and preventive care like Erie provides, a good deal as we see. The second is both basic and sophisticated outpatient testing such as x-rays, mammograms, CT scans and MRIs, to which Erie arranges affordable and deeply discounted linkages with partners. The third is the most expensive – hospitalization, surgery, rehabilitation, and Erie provides linkages as well. And I’m not even going to touch the issue of long term care (a whole other pie).

It’s that first slice of pie, $1.94 per patient per day, which has the most potential to prevent over use of the other two slices. The other two slices are super expensive, their costs are rising, and they are breaking our health care system.

As negotiators try to resurrect health care reform in Washington, they should keep an eye on health centers as a cost-effective and expandable slice of the health care pie. We are ready to do more. END OF POST...Thanks for reading.