Key Takeaways
Group well being facilities are a nationwide community of over 1,300 safety-net major care suppliers, serving greater than 30 million sufferers in 2022. They’re positioned in medically underserved city and rural communities and serve all sufferers no matter their means to pay. Well being facilities additionally performed a serious function within the nation’s response to the coronavirus pandemic, significantly for hard-to-reach populations. This transient analyzes the modifications in well being heart sufferers, companies, and financing from 2019 (pre-pandemic) by way of 2022 utilizing the Uniform Information System (UDS), to which all well being facilities are required to report yearly. Key takeaways embrace the next:
The well being heart affected person inhabitants has returned to pre-pandemic ranges after dipping through the first yr of COVID and is up barely from 29.8 million sufferers in 2019 to 30.5 million in 2022 (2%). However the variety of kids served by well being facilities decreased considerably from 9.2 million to eight.8 million (4%) throughout the identical interval, with the best decline amongst kids ages 0-5. There’s proof indicating that utilization of major and preventive companies amongst kids on Medicaid stays under pre-pandemic ranges, which can partially clarify the drop in pediatric sufferers at well being facilities.
Well being facilities disproportionately served communities of coloration and low-income folks—63% of sufferers had been folks of coloration and over 90% had earnings that was at or under 200% of the federal poverty degree in 2022.
Extra folks had been returning to in-person care for the reason that begin of the pandemic, with over 105 million well being heart affected person visits performed in-person in 2022 as in comparison with 85.7 million in 2020, however telehealth was nonetheless utilized in 17% of all visits in 2022.
From 2019 to 2022, the variety of visits for psychological well being and substance use dysfunction companies elevated 21%, with massive will increase in variety of sufferers recognized with anxiousness problems (26% improve) and a focus deficit problems (21% improve). The variety of sufferers receiving medication-assisted remedy (MAT) for opioid use dysfunction elevated 36% from 2019 to 2022.
From 2019 to 2022, the share of well being heart sufferers who’re uninsured dropped from 23% to 19%, whereas the share of sufferers coated by Medicaid elevated from 49% to 51%, doubtless as a result of Medicaid steady enrollment provision that was in place from March 2020 by way of March 2023.
Medicaid was the biggest income supply for well being facilities, offering 42% of all income in 2022 whereas federal grant funding comprised 12% of complete funding. Well being heart revenues elevated by over $11 billion since 2019, primarily because of development in Medicaid funding associated to the rise in Medicaid sufferers and COVID-related funding.
The unwinding of the Medicaid steady enrollment provision will doubtless affect well being heart sufferers, companies, and financing beginning in 2023 as people who find themselves disenrolled from Medicaid enroll in different protection or turn out to be uninsured. KFF monitoring signifies that greater than 20 million folks have been disenrolled from Medicaid for the reason that begin of the unwinding. Early analysis performed utilizing well being heart claims information discovered that 17% of sufferers who had been coated by Medicaid previous to the beginning of unwinding had been uninsured once they sought care at a well being heart through the first six months of unwinding. Amongst these with the best Medicaid disenrollment charges had been sufferers with HIV/AIDS, psychological well being situations, or SUDs. Whereas Congress just lately reauthorized elevated federal grant funding for well being facilities by way of 2024, the rise could not absolutely offset any drop in Medicaid income through the unwinding. The expiration of pandemic-related funding might additional stress well being heart funds.
Well being Heart Sufferers
The variety of sufferers served by served by well being facilities elevated in 2022, though the variety of little one sufferers has not absolutely rebounded to pre-pandemic ranges. Following non permanent website closures and social distancing steering initially of the coronavirus pandemic in 2020, the variety of sufferers dipped, however in 2021, the variety of sufferers started rising once more and that pattern continued in 2022. Well being facilities served 30.5 million sufferers in 2022, a rise of two% from 2019 (Determine 1). Though the variety of grownup sufferers elevated, the variety of little one sufferers decreased by 4% and stays under the variety of kids served in 2019.
Well being facilities served fewer kids ages 5 and beneath in 2022 in comparison with 2019, driving the general drop in pediatric sufferers. From 2019 to 2022, the variety of kids 0-5 visiting well being facilities decreased 14% from 3.2 million to 2.7 million (Determine 1). The most important decline within the 0-5 age vary was amongst kids beneath age 1, which declined from 688,000 sufferers in 2019 to 471,000 in 2022 (a 32% drop). There was a smaller lower within the variety of sufferers ages 6-11 (3%), whereas kids ages 12 and over noticed a 5% improve over pre-pandemic affected person numbers.
Most well being heart sufferers had been folks of coloration, and the overwhelming majority had been low-income. In 2022, folks of coloration represented 63% of well being heart sufferers and Hispanic sufferers comprised the biggest share of sufferers at 39% (Determine 3). Well being facilities additionally served many sufferers with restricted English proficiency, with roughly one in 4 sufferers (26%) who had been greatest served in a language aside from English. Reflecting their function as safety-net suppliers, 9 in ten well being heart sufferers had incomes that had been at or under 200% of the federal poverty degree (FPL) and two-thirds (66%) had incomes at or under 100% FPL in 2022 (Determine 3).
Well being Heart Companies
At the same time as well being heart sufferers returned to in-person care in 2022, reliance on telehealth continued. Well being facilities offered a complete of 126.9 million visits in 2022, together with 21 million telehealth visits (Determine 4). Telehealth visits represented 17% of complete visits, a considerably bigger share than the 2019 baseline of lower than 1%, however down from the excessive of 25% through the peak of the pandemic in 2020. Whereas in-person visits elevated relative to 2020, they remained under pre-pandemic ranges.
Psychological well being, substance use dysfunction (SUD), and medical companies drove development in well being heart visits from 2019 to 2022, whereas visits for dental and imaginative and prescient companies remained under pre-pandemic ranges. General, well being heart visits had been 3% larger in 2022 in comparison with 2019. Visits for psychological well being and SUD companies elevated by 21%, with extra modest development in enabling companies (9%) and medical companies (4%) (Determine 5). Companies that had been largely offered in particular person, specifically imaginative and prescient and dental, declined by 3% and 17%, respectively, over the identical interval.
Per the rise in psychological well being and SUD visits, the variety of well being heart sufferers recognized with sure psychological well being and SUD problems elevated in 2022. In comparison with 2019, there was a notable improve within the variety of sufferers experiencing anxiousness problems (26%) and a focus deficit and conduct problems (21%) in 2022 (Determine 6). As well as, the variety of sufferers receiving medication-assisted remedy (MAT) for opioid use dysfunction elevated 36% from 2019.
Well being Heart Income Sources
The share of well being heart sufferers who had been uninsured continued to say no whereas the share enrolled in Medicaid surpassed 50%. From 2019 to 2022, the share of uninsured sufferers dropped 4 share factors from 23% to 19% whereas the share of Medicaid sufferers elevated from 49% to 51%, additional solidifying Medicaid as the biggest supply of protection for sufferers (Determine 7). Each of those modifications are largely attributable to the Medicaid steady enrollment provision, which quickly halted Medicaid disenrollments from March 2020 by way of March 2023. After March 2023, states resumed disenrollments as a part of the Medicaid unwinding.
Medicaid continued to be the biggest supply of well being heart income, although federal grants and COVID-related funding had been additionally important income sources in 2022. Medicaid accounted for 42% of well being heart income in 2022 whereas federal Part 330 grant funding, which helps well being facilities function as security web suppliers, made up 12% of revenues at well being facilities nationally (Determine 8). Moreover, pandemic-related funding made up 8% of all well being facilities’ income in 2022 though this funding has since expired. Well being heart revenues elevated by over $11 billion since 2019, primarily because of development in Medicaid funding associated to the rise in Medicaid sufferers and COVID-related funding.
