Community Health Center Models for Improved Care Delivery
One of the challenges of health care reform implementation will be finding ways to efficiently deliver care to the increased numbers of insured people. The federal government has made several recent announcements that will help states in this arena by supporting community health centers. And states themselves have already taken steps to develop and test new care delivery models focused on providing more efficient, higher quality, and patient-centered care.
On November 22, the Department of Health and Human Services announced new funding for the National Health Service Corps Loan Repayment Program which provides financial support to healthcare professionals who work in underserved areas. And two days earlier, $8M in federal funding was released to support training and technical assistance for community-based organizations that support community health centers. This follows $250M for new access pointsfor the delivery of primary health care services for underserved and vulnerable populations.
Through a cooperative agreement with the Health Resources and Services Administration, NASHP has been working with states and community health centers’ state associations to advance better access to higher quality care at a lower cost. To learn more about this work, I interviewed Laura Grossmann, a Policy Analyst with NASHP. Through this program, NASHP works with three-person teams in competitively selected states – a representative of the state Primary Care Association, a representative of the state Primary Care Office, and another state policymaker – to share lessons and advise on strategies to improve access to and delivery of primary care. State officials from NASHP’s Academy also participate, bringing perspectives from Medicaid, Governors’ offices and other key policymaking positions.
From 2007 to 2009, NASHP worked with the first set of six states: Alaska, District of Columbia, Hawaii, Massachusetts, Michigan and Mississippi, to focus on access, cost, and quality in the context of health care reform at the state level. Currently, NASHP is working with teams in: Missouri, New Mexico, Oregon, Pennsylvania, Rhode Island and Tennessee, to identify and move forward on key strategies to transform health care delivery systems. Many of these efforts are focused on new opportunities presented by the ACA.
State Refor(u)m has posted workforce development resources from some of the states participating in this NASHP project, as well as other states.
- New Mexico’s “Roadmap” includes a section on primary care capacity.
- Julia Dyck of Massachusetts shared her state’s experience with health reform at NASHP’s 2010 annual conference. Her slides are available here.
- The Rhode Island task force report on health reform implementation includes a section on workforce development.
- Maryland’s HealthCare Delivery System Workgroup Report examines primary care access, reimbursement, and medical homes, among other issues.
- Washington’s presentation to the legislature on workforce shortages outlines six goals for the state.
What is your state doing to improve primary care delivery and ready the workforce for a post health-reform world? Tell us at State Refor(u)m.

For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 























































































































































