New Report says Payment Reform Could Strengthen Family Planning Services Offered by the Nation’s Community Health Centers

A new report issued by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative and the Jacobs Institute of Women’s Health, based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University, describes how payment reform could improve family planning services offered by the nation’s community health centers.  In 2013, 1,200 community health centers operating in more than 9,100 urban and rural locations furnished comprehensive primary health care to nearly 22 million people living in communities and populations facing elevated health risks and a shortage of primary health care. They also provided care to one in five low-income women of childbearing age nationally. Family planning represents a required service provided by virtually all health centers in the United States.

Although family planning is a health service available through health centers, a first-of-its kind study published in 2013 by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative and the Jacobs Institute found that health centers show considerable variation in the scope and quality of the care they furnish. This latest report concludes that payment reform could strengthen the quality of family planning services at health centers by improving access to the most effective forms of contraceptives along with family planning counseling services, which have been shown to be highly effective in reducing unplanned pregnancies and childbearing. Unplanned childbearing is significantly associated with infant mortality and a host of maternal, child and family health risks such as low birth weight, abuse and neglect, and elevated poverty.

“Comprehensive family planning repeatedly has been shown to be one of the most effective and cost effective forms of preventive health care, “said lead author Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy at the Milken Institute SPH.  “Elevating the quality of family planning programs at health centers is central to patient, family, and community health.”

The report, which comes at a time of heightened interest in using payment reform to improve the quality and efficiency of health care as well as patient and population health, recommends a combination of payment reforms coupled with payment incentives tied to evidence-based quality improvement measures drawn from a landmark set of recommendations for improving the quality of family planning services issued by HHS in 2014. The analysis also calls for investments by HRSA in the staffing and supplies needed by health centers.

 “This combination of up-front investments,  coupled with payment strategies that sustain expanded services over time, holds enormous promise for long term improvement in care,” adds Susan F. Wood, PhD, also a lead  study author and the Executive Director of the Jacobs Institute of Women’s Health at the Milken Institute SPH.

“The recommendations contained in this report reflect the type of important thinking that is needed to enable health centers to build on their strong record of achievement in caring for medically underserved populations,” said Feygele Jacobs, President and CEO of the RCHN Community Health Foundation.

The report, “Using Payment Reform Strategies to Strengthen Family Planning Services at Community Health Centers,” was authored by Sara Rosenbaum, Peter Shin, Susan F. Wood, and Jessica Sharac of the Milken Institute SPH Department of Health Policy.