VNA Community Health Center fills key niche in community
As a Federally Qualified Health Center, VNA Community Health Center serves wide array of patients
May 14, 2016
Craig — As a Federally Qualified Health Center, the Northwest Colorado Visiting Nurse Association's Community Health Center fills a key niche in the community.
The Community Health Center has three primary care doctors on staff, along with four physician assistants and one nurse practitioner. Six of the eight providers divide work time between Craig and Steamboat Springs, with two physician assistants working only in Craig.
Gisela Garrison, director of the Northwest Colorado VNA Community Health Center, said salaries for primary care physicians at the VNA are lower than in the private sector — but she also noted advantages.
"The payment for our primary care physicians is definitely much lower than in the private sector," she said. "It takes a certain person, personality-wise, who wants to work with much less money than they would get in the private market. But overall I feel like the benefits of working in an FQ for the right person outweigh the lack of money."
According to the U.S. Department of Health and Human Services' website, "Federally qualified health centers (FQHCs) include all organizations receiving grants under Section 330 of the Public Health Service Act (PHS)," and they "qualify for enhanced reimbursement from Medicare and Medicaid, as well as other benefits."
To qualify as FQHCs, the centers "must serve an underserved area or population, offer a sliding fee scale, provide comprehensive services, have an ongoing quality assurance program, and have a governing board of directors."
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Garrison said the VNA Community Health Center’s status as an FQHS allows it to offer strong benefits to its providers — benefits that have helped it to recruit and retain physicians. That status enables the center to provide liability insurance for its providers, and Garrison said the federal government also provides loan repayment.
"We have not lost a primary care M.D. in the eight years that we have been working as a primary care (facility)," Garrison said, noting a high retention rate for the other providers, as well.
Garrison described the way the role of primary care providers has expanded.
"Health care is shifting," Garrison said. "We ask a lot of our primary care providers in the sense of patient-centered team-based care."
And with the greater prevalence of Medicaid, primary care doctors are able to see more people — but it's the next step that can be more difficult.
"Very few specialists accept Medicaid clients or uninsured clients," she said. "It's a really big issue in all communities — here too. That means that much more challenging work falls to the primary care provider. That is a special burden for them. Not that they don't want to work hard — on the contrary, they work really hard."
In this community, Garrison said, some specialists do accept Medicaid, and some don't.
"This is a challenge for any primary care provider," she said.
Garrison said the reimbursement rate for Medicaid is much less than it is for private services, and she noted work by the Centers for Medicare & Medicaid Services to increase Medicaid reimbursement rates for services.
"But it's a question of finances, and it is a very complex issue," she said.
Garrison noted, too, that the Community Health Center in Craig is about twice as busy as the Community Health Center in Steamboat Springs.
"It's more established (in Craig)," she said. "It's older. We are in our eighth year now. And secondly, in 2007 and 2008, when the VNA agency decided to apply for federal funding to establish a community clinic, at that time there was a high number of uninsured patients here in this community who did not have any access to primary care. Also, very few of the primary care providers would accept Medicaid clients at that time. So, we filled an enormous need for primary care services for uninsured and Medicaid clients."
In Craig, even as more providers began accepting Medicaid, the VNA had already become the established place of care for many patients.
"We already had a core of clients that stayed with us," she said.