Cortez Integrated Health, a major provider of primary, pediatric and mental health care in Montezuma County, was recently awarded $541,667 from the U.S. Department of Health and Human Services to further develop its “comprehensive care” model.
With the grant funding also comes the designation of Community Health Center, a federal designation that allows it to net higher reimbursements for the high volume of Medicaid and Medicare patients it sees.
The grant funding will be used to help the center expand its patient base – regardless of the patient’s ability to pay – and recruit two more physicians.
“The intention (of a Community Health Center) is to provide a time-tested, high-caliber, comprehensive primary care structure to an expanded population of folks who now have insurance under the Affordable Care Act and Medicaid expansion,” said Bern Heath, CEO of Axis Health System.
The Community Health Center structure differs from a traditional primary clinic’s structure, in that they provide multiple services under one roof including pediatrics, counseling services, health promotion and education, case management, advocacy, and intervention.
The health-care delivery models have been expanded under the Affordable Care Act, with the intention of improving outcomes for patients by bolstering preventative and interventionist care. The vision is that by increasing access to preventative services, usage of higher cost speciality and emergency room services will be reduced.
“We’re not a mental health center providing primary care, or a primary care center providing mental health — we don’t make that distinction. We treat the whole person, that is an integrated health model,” said Heath.
Community Health Centers are also designed to provide access to all patients, whether they have private insurance, government-issued health care coverage like Medicaid and Medicare patients, or no insurance at all.
Since a stipulation of federal Community Health Centers is that they serve areas considered medically underserved, they also regularly receive a mix of grant funds and higher Medicaid and Medicare reimbursement rates to help offset the cost of taking on these patients.
Heath says that La Plata and Montezuma County have roughly the same number of Medicaid and Medicare patients, but the population in Montezuma County is about half of La Plata’s. That means the percentage of the Medicaid and Medicare patients in Montezuma County is actually doubled in comparison.
Although the designation allows Cortez Integrated Health to take on more Medicaid and Medicare patients — as well as those under and uninsured via a sliding pay scale — Heath stresses that it doesn’t position the facility as a competitor with Southwest Memorial Health System or other private primary care practitioners in the area.
“This expansion and these resources really complete the primary care infrastructure for Montezuma County,” said Heath. He added that the Community Health Center designation can actually be a boon to local health care entities, by reducing their financial strain of high Medicaid and Medicare patient volumes.
“We’re not interested in getting bigger for big’s sake; we’re interested in being able to provide the best care,” he said.
As part of the grant stipulation, Cortez Integrated Health has to have the Community Health Center model in place in 120 days. Heath expects the transition to be complete in late August or early September.