Painting a portrait of utilization: Medicare and nursing managed health centers

It is estimated that 60 million Americans lack adequate access to primary care as a direct result of the shortage of primary care providers. Additionally, The Patient Protection and Affordable Care Act will add up to 34 million more insured Americans into the health care system, placing further strain on the existing shortage of primary care providers. Nurse managed health centers (NMHCs) have been identified as a critical piece of the health care safety net equipped to provide primary care, health promotion and disease prevention to vulnerable populations, consistent with the medical home model. Anecdotally, it has been noted that NMHCs are under-utilized by the older adult population and there is no existing comprehensive data set regarding NMHC billing or clientele. This study conducted a descriptive analysis of the population of Medicare beneficiaries served by nurse managed health centers. The patient population was described with respect to socio-demographic characteristics (e.g., age, sex, race), types of services, service level intensity, the portion of NMHC population that is dual-eligible, and geographic areas of care concentration. This is phase one of a two-phase study. This data will inform a qualitative inquiry to evaluate facilitators and barriers to full integration of NMHCs as patient-centered medical homes for Medicare beneficiaries.