What Role do SBHCs Play in Health Reform?

By Serina Reckling, Policy AnalystSchool-Based Health Alliance

I was ecstatic when I joined the policy team at the School-Based Health Alliance back in 2011. Health reform had been in effect for about a year, and with $200 million in federal grant awards given to 450 organizations to support the construction and renovation of school-based health centers (SBHCs), I believed that I was joining a field that would play a critical role in reforming the health care delivery system for children and adolescents.

But within few months into my job I was discouraged to learn that SBHCs were not on the radar of most key health care reform players. The recognition of SBHCs as a delivery model was growing, but as health care payers and policymakers focused their delivery reform efforts on expensive hospital visits and adults with chronic disease, the needs of children and adolescents–and SBHCs as critical providers–were largely forgotten. Nevertheless, the School-Based Health Alliance, our state affiliates, state SBHC program offices, and others continued to push for the integration of SBHCs into national and state health care reform efforts.

Our hard work is paying off. SBHCs are finally players in the health care reform arena.

At the state-level, SBHC advocates are at the table providing input and negotiating policies affecting their state’s Medicaid payment and system redesign efforts. For example, advocates in Oregon and Connecticut were successful in including SBHCs as eligible providers in their state’s patient-centered medical home programs. Oregon SBHCs are also participating in their local coordinated care organization reform efforts and California SBHCs are connecting families to health insurance coverage offered through their state health insurance marketplace.

At the national-level, we are getting calls from large health insurance plans that want to learn more about SBHCs and partner with SBHCs to deliver high quality care to children and adolescents in their networks. Their presence at the 2014 National Convention speaks to their growing commitment and interest in our model:

  • Four health plans sponsored the convention: Amerigroup, Molina Healthcare, UnitedHealthcare Community Plan, and Community Health Plan of Washington.
  • Sixteen attendees representing four health plans attended the convention.
  • Two health plan representatives participated in an engaging conversation with 25 state affiliate leaders to discuss the value-added of SBHCs in the eyes of health plans and how they want to partner with SBHCs to improve the health outcomes of children and adolescents in their networks.
  • Our closing plenary speaker, Dr. Raymond J. Baxter, Senior Vice President for Community Benefit at Kaiser Permanente talked about SBHCs as catalysts for change resulting in new community-based systems of care, joint advocacy for policy change, and positively impacting social determinants of health and education and health outcomes.

I left Seattle excited and full of hope. I’m excited that more and more health plans are finally seeing the value-added of SBHCs delivering care to children and adolescents in their networks. And I’m hopeful that SBHC field continues to build its relationship with health plans and integrate into health care payment and delivery redesign efforts. Now is the window of opportunity for SBHCs to play a critical role in reforming the healthcare delivery system for children and adolescents. The health care payers are interested and listening.

How are SBHCs participating in your state health reform efforts?

How are you partnering with local health plans?

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