RAHC Building Expansion Information

The Rockbridge Area Health Center transitioned to a community health center in February 2014 to provide increased access to health services to more residents in our area. In addition to providing comprehensive primary health care services, the RAHC offers specialty care, dental and mental health services, as well as supportive services that include medication assistance, nutrition education, translation services, care coordination and case management, transportation, 24 hour nurse assistance and outreach activities to insured, uninsured, Medicaid and Medicare patients.

Mission.  The mission of the Rockbridge Area Health Center is to promote and provide access to comprehensive, high quality and affordable health care to improve the health and well-being of our community.

Vision.  The vision of the Rockbridge Area Health Center is to serve as a vital and caring Rockbridge area resource promoting and providing access to quality health care to build a healthier community.

RAHC served over 5,900 patients by the end of 2018 and with over 18,000 patient visits.  A community health needs assessment completed in 2012 identified a chief health priority to expand access to health services. The Rockbridge area is a Medically Underserved Area. Findings from the needs assessment include:

• In the Rockbridge area, 38 % of residents are low-income.^[1]
• Approximately 19% of Rockbridge area adults are uninsured.^[2]
• Low-income residents of Buena Vista, Lexington, and Rockbridge County are designated a Medically Underserved Population and a Primary Care Health Professional Shortage Area.
• The Community Health Needs Assessment process is an on-going public/private activity involving numerous community organizations. Assessments were completed in 2012, 2015 and 2018.

[1]American Community Survey, 5-Year Estimates, US Census Bureau, 2006-2010

[2]Virginia Atlas of Community Health, 2011

Absolutely.

RAHC is a key safety net for many and is able to provide a medical home to Medicaid recipients. Increasingly, fewer primary providers in the community are accepting Medicaid patients.

The expansion of Medicaid allows individuals with incomes of up to 138% of the federal poverty level to receive health insurance through the Medicaid program, and is roviding new coverage for 400,000 Virginians.

Findings from the community health needs assessment of the Rockbridge area included the following:

• “Low-income” is defined by HRSA as an income at or below 200% of the Federal Poverty Level.
• In the Rockbridge area, 38 % of residents are low-income.

Medicaid expansion will not apply to everyone, especially to the country’s working poor and there are those who make too much in wages to be eligible.

• Everyone and encompassing all life cycles
• Those without access to other health services (includes the low-income, uninsured)
• Uninsured or insured (includes Medicare, Medicaid and private insurance)

No.

RAHC is meeting the healthcare needs of the community’s most vulnerable residents.  Insured patients and those with higher incomes that use services provided by RAHC actually support the provision of services to the uninsured and underinsured by contributing to the fiscal health of the organization.

• Accessibility
• Accountability
• Comprehensiveness of Care
• Coordination and Continuity of Care
• Health and Wellness Promotion and Disease Prevention

• Infuses $1.5 to $1.8 million into the local economy.
• Employs over 73 people in the community and recruits providers from outside the area.
• Created over 47 new jobs between 2014 and 2018.
• Employs clinical and administrative-based jobs which boosts the local economy.
• Purchases goods and services from local businesses.
• Partners with other agencies and service providers in the area.
• Provides school-based dental services in all local public schools Pre-K-12 twice yearly and serviced over 1,800 students in 2018.
• Is community-based and patient driven and can quickly identify community-based solutions to ever-evolving healthcare needs.
• Engages in capital and community development projects that promote economic revitalization.
• Seeks to keep the community healthy and in the workplace.

Expanding and strengthening the health center further reduces health disparities, increases access to high quality and regular care and boosts the local economy. As a result, fewer people would rely on costly sources of care, thereby saving tax payers significantly and making the overall health care system more efficient. Health Centers are good public investments that generate substantial benefits for patients, communities, insurers and governments.

Sustainability begins with providing accessible services the community needs in terms of services offered and the appropriate physical space necessary to provide those services efficiently and effectively. Typically, as community health centers mature, the portion of their budget represented by federal funding decreases. RAHC focuses on maximizing capacity from existing resources. This includes addressing workforce needs, increasing productivity, and improving operations and care delivery. Expanding internal capacity by addressing healthcare gaps in the community such as dental care, pediatric and women’s health care will support future sustainability. Expanding pediatric services will lead to many more visits. Well-child checks recommend eight visits in the child’s first year of life. There are an additional three well-child checks recommended from the age of one to two years of age. This does not consider pediatric sick-visits. Because children tend to be insured more than persons age 21 and older, the vast majority of these visits will be reimbursable by insurance (private insurance or Medicaid). Marketing to and expanding women’s care at RAHC will also lead to increased visits. A 2014 study found that women make 80% of the health care decisions for their family[1].

[1]Sabrina Matoff- Stepp, PhD, et. al. Women as Health Care Decision-Makers: Implications for Health Care

Coverage in the United States, Journal of Health Care for the Poor and Underserved 25 (2014): 1507–1513.

[1]Sabrina Matoff- Stepp, PhD, et. al. Women as Health Care Decision-Makers: Implications for Health Care

No.

Multiple primary care specialties including medical, dental and behavioral health provide patients with a holistic, single source of care. The ability to provide and manage patient care across these in-house services is associated with lower health care costs and improved patient outcomes. Each specialty carries its own unique space needs. Emerging models of care are placing increasing emphasis on patient education and group programs that help patients manage their health. The cost of the new 28,000-sq. ft. RAHC facility is consistent with the cost of new community health center buildings in our region over the last six years and their respective patient populations including the Harrisonburg Community Health Center (2012), the New Horizons Health Center in Roanoke (2012) and the Blue Ridge Medical Center in Nelson County (2011).

• The Harrisonburg Community Health Center built a 21,000-sq. ft. facility with 16 exam rooms for medical services and a four operatory dental clinic. The facility included 4,000 sq. ft. for a leased pharmacy. The cost of the facility was $4.2 million. The space did not include public use space for patient group education. By 2015, health center representatives stated the facility was out-of-space having served 6,300 patients.
• In 2012, New Horizons Health Center in Roanoke constructed a 32,000-sq. ft. facility at a cost of $10 million. The facility includes medical, dental, behavioral health an in-house pharmacy and space for group/patient education. New Horizons served 8,710 patients in 2016. Their CEO said that within two years of occupying the new facility, they were out of space with a patient population of 6,700 (2014).
• In 2011, the Blue Ridge Medical Center opened a new 28,600-sq. ft. facility in Arrington (southern Nelson County.  The facility included medical, dental and behavioral health and an in-house pharmacy.  In 2016 the health center serviced 7,888 patients.
• RAHC had nearly 6,000 patients at the end of 2018 and over 18,000 patient visits. In addition to patient demands, expanding services and an emphasis on patient education and population health, the new RAHC facility should be considered within the context of a physician shortage that looms over the nation, particularly for rural health settings. The Council on Graduate Medical Education projects a shortage of 85,000 physicians in 2020. The Association of American Medical Colleges (AAMC) predicts this shortage will grow to 124,000 physicians by 2025. The average age of registered nurses (RNs) is rising, with more than half of all RNs are at least 40 years old and 40 percent are over the age of 50. The recruitment and retention of health center staff is critical to our success. While our community boasts natural beauty and has access to larger communities, a modern facility designed as a health care center (as opposed to our current facility) equipped with the necessary equipment and information technology to support the provision of quality healthcare is an important component in RAHC’s recruiting and retention strategy.

The Health Center does not receive any state mandated funds.  It is a private, nonprofit, 501 c 3 corporation that grew from a recognized need within the Rockbridge community. Community health centers tailor the services provided to meet the unique needs of the community in which they are located.