“There are some early whispers about that money being provided to new access points, which means expanding the number of organizations and operational sites,” said Jonathan Chapman, executive director of the Louisiana Primary Care Association.

The process is competitive, and it’s too early to tell whether the federal Health Resources and Services Administration will choose any new centers in Louisiana that will receive funding, Chapman said.

The Louisiana Primary Care Association is the trade association for the state’s 83 federally qualified health centers, which treated nearly 207,000 patients in 2010. The bulk of the centers’ revenue comes from federal grants, Medicaid, and non-federal grants or contracts.

There are more than 1,200 centers nationwide, and the facilities provide care for more than 20 million people a year, according to the National Association of Community Health Centers. The centers serve the most vulnerable patients, those whose language, complex healthcare needs or living areas isolate them from traditional medical care.

Almost all of the centers’ patients fall at or below the poverty line, according to the national association. The uninsured and publicly insured and minorities are also disproportionately represented.

In the most recent federal funding round, Louisiana submitted 21 grant applications to start and fund new centers in medically underserved areas. There were more than 700 grant applications nationwide, and only 67 received funding.

The $200 million in additional grant funding will allow the centers to care for nearly 1.5 million people, according to the National Association of Community Health Centers.

The national association’s position has been that if more funding became available, new centers should receive that money, Chapman said. He is hoping that some of the proposed Louisiana centers scored high enough on their applications to qualify for the additional funding.

Donald Hunter, membership services coordinator for the Louisiana Primary Care Association, said securing the added funding was “a great, great victory” considering the fiscal climate in Washington, D.C.

The state’s need for the health centers, already great, has grown in recent years, Hunter said.

The majority of Louisiana’s parishes are health-professional shortage areas, he said. The economic downturn, a shrinking state general fund, and cuts to the state Department of Health and Hospitals’ Office of Public Health means the federally qualified centers are needed now more than ever.

The centers provide a cost-effective means of caring for the uninsured and patients enrolled in Medicaid, Hunter said.

Federally qualified health centers save the United States an average of $24 billion in health care costs each year, according to a study conducted by George Washington University.

The centers serve 14 percent of all Medicaid beneficiaries but account for only 1 percent of Medicaid spending, Hunter said.

“There is no greater investment in healthcare dollars,” he said.

In 2010, of the average health center’s payor mix, 44 percent were uninsured patients; 38 percent were covered by Medicaid; 11 percent by private insurance; and 7 percent by Medicare, according to figures compiled by the U.S. Department of Health and Human Services.

The uninsured are charged on a sliding fee scale, based on their ability to pay, Hunter said. The federal grant dollars help subsidize the uninsured patients’ care.

The centers, in Louisiana and other states, and the primary care physicians who staff them provide much-needed treatment and preventive care, Hunter said. Without the centers, more of the uninsured and Medicaid populations will end up in emergency rooms, boosting the cost of healthcare.

The centers are part of the Obama administration’s effort to increase care for the uninsured and underinsured.

The Patient Protection and Affordable Care Act calls for spending $9 billion over a five-year period to expand the centers, and ultimately provide services for an additional 30 million Americans, Hunter said.

The projected funding was $1 billion in 2011; $1.2 billion in 2012; $1.5 billion in 2013; $2.2 billion in 2014; and $3.6 billion in 2015.

However, Congress cut the 2011 funding for expanding the centers by $600 million, Hunter said. Louisiana managed to hang onto several centers that originally started under the American Reinvestment and Recovery Act, and Louisiana was able to save seven centers, while 130 nationwide were funded, according to Hunter.

Hunter said the centers are also concerned about the buzz going on in Washington that entitlement programs, such as Medicaid, need to be changed.

On average, approximately 29 percent of the centers’ revenue comes from the Medicaid program, Hunter said. Any kind of changes in reimbursement or exclusions could affect the centers’ ability to treat patients.

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