THANK YOU, advocates, for participating in NACHC’s first Policy Poll to share what you believe are the most important policy priorities for health centers! We heard from 1,286 of you in all 50 states, DC, and Puerto Rico who answered two simple questions: (1) “What should be NACHC’s top policy priority?” and (2) “Are there any other policy priorities NACHC should focus on?”
After reading each and every response from the Policy Poll, our policy team has gained greater insight into the policy priorities that are most important to you. The results of this poll will serve as an essential part of NACHC’s process for developing a comprehensive policy agenda to advocate for health centers and the patients they serve.
In this blog post, we want to say thank you by summarizing our key takeaways from the Policy Poll and provide more details on how we will apply it to advocate for health centers and their patients.
Key Takeaways from the Policy Poll
#1: Many advocates are directly connected to a health center and have a lot at stake when it comes to health care policy decisions.
Of the 1,286 advocates that responded to the Policy Poll, the vast majority (80%) work at a health center and another 9% of respondents work in a Primary Care Association or Health Center Network/Consortia. We also heard from health center patients (4% of respondents), as well as others that work in government, academia, and non-profits and other organizations that support health centers. We at NACHC were very happy to see that many of the other respondents are former health center staff and board members, which we interpreted as evidence that you never really stop working to make affordable, high quality health care accessible to everyone.
#2: At first glance, the most common policy priority from advocates is federal and state funding by a long shot.
[NACHC’s top policy priority should be…] “You mean besides funding? Because definitely funding first! After that, we should continue to protect Medicaid from block granting, waivers, work requirements, etc.” – PCA/HCCN Staff Member
In our first look at responses, funding seemed to be a top priority. For example, 17 different respondents from 12 different states across the U.S. had a 1-word answer when we asked what should be NACHC’s top policy priority. The one word: “Funding.” When you look at the most commonly used words in response to the Policy Poll, funding is a clear priority.
Funding is by far the most commonly used word, but there are many other important policy issues here too! For example, many of the responses were very patient-centered: “patient” and “patients” are very commonly used words, and words like “access,” “affordability,” and “quality” convey concern for patients’ wellbeing (although “quality” was also used to describe quality improvement, which is not necessarily as patient-focused). Additionally, “Medicaid,” “insurance,” “reimbursement,” and “340B” were also among the most frequently used words, showing that payment models beyond grant funding are among the most mentioned policy concerns.
#3: Once you read into the responses, it’s clear that the Health Center Movement is much more than funding.
Comprehensive health care must be accessible & compassionate. There's a significant ongoing barrier to forming a provider-patient relationship because providers simply do not have the time to do so. When providers are double- & triple-booked & allotted only 15 minutes per patient, it leaves providers overworked & patients feeling uncared for. Perhaps w/ more funding, we'd have more providers/resources? – Community Health Care Manager in CO
In order to see the bigger picture, NACHC staff read through each response, created eight “broad buckets” to classify responses, and then categorized advocates’ responses to the question, “What should be NACHC’s top policy priority?” When we read into responses this way, a different perspective emerges.
With a bit more context, we can see that policies related to accessibility were mentioned as much as – if not more than – funding issues. “Payment” models were also virtually tied with funding in terms of mentions, which focuses more on patient-related revenues for health center services. These are broad categories that fit a lot of different policy issues within them and are very helpful!
We also created over 30 categories that are more specific. To find out more about how we categorized responses, click here.
#4: A lot of issues are interrelated, and most advocates’ responses touched on several policy areas.
I am a strong advocate for understanding the reasons for poor health. And more evidence points to social determinants. Health Centers, unlike traditional medical providers, have been working toward addressing these issues through social services and programs that are not traditionally funded by the Medicaid and Medicare nor insurance. Nutrition, exercise, weight loss, group and peer programs. – Health Center Staff Member in IL
In the end, it is difficult – if not impossible – to separate many of the issues raised in the Policy Poll, and many advocates touched on several issues when asked to name their top policy priority. For example, the quote from an Illinois staff member touches on the social determinants of health (such as housing, food security, etc.) as well as payment issues and Medicaid and Medicare. It is much more difficult to solve the one problem without fixing the others first! This was a common theme throughout the responses, and one that we are keeping top of mind as we develop a comprehensive policy agenda to advocate for health centers.
How We Are Applying the Policy Poll to Advocate for Health Centers
The Policy Poll is one part of a months-long process to make sure we highlight the most important and effective policies to help health centers carry out their mission. Specifically, we are utilizing three key components to build an effective comprehensive policy agenda.
Beginning in June 2018, NACHC began outlining what we thought were the most important policy components to ensure health centers and their patients can thrive. This initial stage took two full months and the final product from this stage can be described as a beefed-up grocery list, composed of bullet points and a summary of why each item was on the list. We were careful not to fill in too much because we wanted to hear from you all!
We took our outline to the Community Health Institute (CHI), NACHC’s largest conference, to get feedback from the subject matter experts (such as health center CEOs and PCA/HCCN staff) by hosting two separate break-out sessions with leaders in 10 key policy areas, such as rural health, service integration, social determinants of health, funding, Medicaid, Medicare, and others. What we learned from the feedback at CHI was incredibly valuable for recognizing policies, problems, and potential partner organizations that NACHC hadn’t yet considered.
The Policy Poll was designed to reach beyond attendees at CHI and NACHC’s Policy Committee. We wanted feedback from frontline staff, patients, and anyone with a stake in the Health Center Movement willing to fill out a short questionnaire. We also wanted you to tell us what your priorities were, which is why we opted for an open-ended response in the Policy Poll.
In addition to reading through the responses and the key takeaways listed above, NACHC staff will be able to read responses that focus on specific policies while we are working on the comprehensive policy agenda. Additionally, we will use the Policy Poll to help us advocate for specific policies in the future as they are being drafted. Ultimately, we are applying your responses to the Policy Poll wherever we can.
THANK YOU! THANK YOU! THANK YOU!
Once again, THANK YOU advocates, for sharing your most important policy priorities by taking part in the Policy Poll! Your input is a critical component in developing a comprehensive policy agenda and will be a go-to resource as we work on other health policies that pop-up along the way. We learned a lot, and we can’t thank you enough for your time and thoughtful responses. Stay tuned for updates as we continue to build out our policy agenda.