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Health centers ease burden on hospitals

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Berks County has a great need for affordable primary health care.

That’s why local leaders opened a nonprofit health center in Reading in June 2012, designed for uninsured, underinsured and government-insured people.

Such government-subsidized centers (there’s also one in Allentown) not only benefit poor people. Known as federally qualified health centers, they relieve hospitals and improve the general business climate in the region.

How has the Berks Community Health Center succeeded?

Type “Berks health care” into Google and likely the top result is the Berks Community Health Center, higher on the list than the two hospitals – St. Joseph Medical Center and Reading Hospital.

In business terms, its growth is admirable. The center has nearly 7,000 patients and grows by 150 a month. It has 42 staff members, up from 28 when it started. The team includes a social worker, people who work on the center’s electronic medical records and a grant writer.

Mary H. Kagbo, CEO, said she plans to add two care providers to the two physicians and three nurse practitioners who work there now. With more providers, the center could serve many more people – and the need is great, Kagbo said.

Almost 72,000 people in Berks – 18 percent of the population – use Medicaid, the government health-insurance plan for poor people, according to U.S. Census estimates. More than 39,000 live in Reading – 45 percent of the city’s population. Those numbers don’t include the many uninsured people who need care.

An assessment released last January cited the need for better access to health care in Berks. Work by the Berks Medical Society and the local United Way showed the need for more primary care.

St. Joseph Medical Center runs a similar center a few blocks away at Sixth and Walnut streets that serves the same population as the FQHC.

“Given the amount of care provided on our campus, there is much need in the community,” St. Joseph spokesman Michael Jupina said in an email.

“The need is much greater than the two centers can handle,” Kagbo said.

One problem is that few primary-care physicians in Berks accept new Medicaid patients. That’s because the government reimbursements are not fair, and not because doctors are greedy, Kagbo said.

In any case, many people who can’t get a doctor’s appointment go to the local emergency rooms for routine care, knowing they can’t be turned away.

In 2012, patients made 176,505 visits to Berks County emergency rooms – up 23 percent from 2007, according to the state. That year in Lehigh County, patients made 326,874 emergency-room visits, up 24 percent from 2007.

“I think that’s because no one is taking care of this population,” Kagbo said.

One of the main goals of the federal health-center program is to discourage unnecessary visits to hospital emergency departments. Also, the centers provide preventive care, which should reduce hospitalizations.

In 2012, nearly one out of five patients hospitalized in Berks used Medicaid.

Health centers yield substantial cost savings to the health care system – an average of $1,200 per patient – by reducing emergency department visits, hospitalizations and other avoidable, costly care, according to the Pennsylvania Association of Community Health Centers.

In medically underserved areas, providing health care to uninsured people puts pressure on hospital costs, said Gary Rightmire, chairman of the health center’s board.

“In many communities, hospitals have been put out of business,” he said.

In 2013, Reading Health System provided $152 million in charity care, unreimbursed care and uncompensated care, vice president Mary Bligh wrote in an email.

“In a health care system where resources are increasingly precious, any assistance to defray this charity care expense will benefit the community,” she wrote. “The FQHC is one such innovative approach toward new models of health care delivery to improve primary care and care coordination while reducing costs.

“Its success will allow hospitals like ours to devote more resources to more sophisticated technology and equipment and improved care, benefiting all the health care consumers of Berks County.”

Reading Hospital ran a health dispensary at the same site in Reading from 2000 until handing it over to the community health center, offering appointments and drop-in and urgent care. A hospital press release cited annual losses of $3.1 million.

Business leaders have reason to care about health access for everybody in their communities.

“FQHC is helping build a healthier community, and a healthier community is good for business in Berks County,” Bligh wrote.

Health centers attract business because employers realize healthy people are better workers. The importance of funding such health centers is one issue Republicans and Democrats agree on, Rightmire said.

Thanks to those politicians, FQHCs have an edge in the health care market because the government pays them higher reimbursements for providing health care than it does to private doctors.

The Reading center also gets a federal grant of $650,000 a year. Reading Hospital donates $1.2 million a year. A fund set up when the former Community General Hospital was dissolved provides $125,000.

The United Way and other donors provide funds. And the center seeks donations like any nonprofit, Kagbo said.

Kagbo and Rightmire said it was too early to tell if the center has put a dent in emergency-room visits.

St. Joseph has not seen a change in emergency-department volume because the FQHC has simply taken over Reading Hospital’s operations there, Jupina said.

St. Joseph provides the largest outpatient clinic in Berks County at its downtown Reading campus at Sixth and Walnut streets, with about 220,000 annual patient encounters. It provides about the same services as the FQHC does.

Reading Health System has a children’s health center, women’s health center and family health center at the hospital campus in West Reading and runs the Second Street Dispensary in Reading to provide primary care, Bligh said.

Kagbo’s goals are to continue to attract patients and then open satellite centers. There are plans to offer dental and mental care.

And Kagbo doesn’t ignore marketing. A big goal is to better educate the community about the center and its purpose, Kagbo said.

The center has programs in Spanish on Albright College’s radio station and on Berks Community Television. A two-person outreach team visits churches, day cares, schools, public laundries, salons, barbershops and other city gathering places to spread the news.

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