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Conference attendees outline research agenda for community and migrant health centers

Changes in health care financing will affect the future of community and migrant health centers (C/MHCs). For example, the shift to managed care in State Medicaid programs and the growing number of uninsured people will challenge the abilities of C/MHCs to provide a safety net of health care in their communities. The Agency for Health Care Policy and Research (HS09364) supported a conference on this topic for health care practitioners and university-based researchers, which was held July 17-18, 1997, in Kansas City, MO. The goal of the conference was to build a research agenda that is responsive to the needs of C/MHCs. Research ideas were classified into three general categories: outcomes research, managed care applications and finance issues, and service delivery.

The following outcomes research priorities were identified as most important: patient satisfaction with CHC services; effectiveness of special, targeted programs to address health improvement, especially those that rely on patient compliance; the impact of the health center on the health status of the people served and the community; the impact of enabling services, such as transportation and language translation, on health outcomes; and differences in patient outcomes related to differences in access to specialists.

Discussion of managed care and finance issues focused on research to understand how changes in finance will affect total center operations. These included the impact of direct contracting with Medicaid or others on center finances, clinical services, and on the ability to network with other providers. Participants also gave priority to research on the effects of changes in finance on access to care—for example, for counties with or without a C/MHC—or for patients enrolled in C/MHC managed care plans compared with other managed care providers. Service delivery outcomes research priorities ranged from the role of grant support in sustaining C/MHC activities to the role of clinicians in C/MHC decisionmaking.

See "Building a research agenda: Responding to the needs of community and migrant health centers," by Keith J. Mueller, Ph.D., Thomas Curtin, M.D., Daniel Hawkins, and others, in the Fall 1998 issue of the Journal of Rural Health 14(4), pp. 289-294.

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