Geiger Gibson / RCHN Community Health Foundation Research Collaborative, issuing body.
Geiger Gibson Program in Community Health Policy, issuing body.
George Washington University, issuing body.
Milken Institute School of Public Health, issuing body.
[Washington, D.C.] : Milken Institute School of Public Health, George Washington University, August 2018
In a recent decision, the United States Court of Appeals for the Fifth Circuit in Legacy Community Health Services v. Smith held that state Medicaid programs may refuse to pay community health centers for the non-emergency, out-of-network care they furnish to Medicaid managed care enrollees. This issue brief discusses the national implications of this ruling and estimates the economic impact on community health centers, their staff, and their patients nationally if the decision stands. Our estimate of potential losses suggest that community health centers nationwide could lose between $1.0 and $2.0 billion in revenue annually, an amount that translates into between 4.3 percent and 8.6 percent of total community health center revenue. Losses of this magnitude translate into the loss of as many as 8,900 to 17,800 community health center jobs and would reduce the number of patients served by as many as 1.1 million to 2.2 million per year.
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