WASHINGTON, DC (December 23, 2020)—More female patients at community health centers (CHCs) received six recommended preventive services following implementation of the Affordable Care Act (ACA), found a new study selected as the Editor’s Choice for the January/February issue of Women’s Health Issues.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Brigit Hatch of Oregon Health & Science University (OHSU), along with her colleagues from OHSU and OCHIN, Inc., used electronic health record data from the ADVANCE Clinical Research Network to examine receipt of cervical cancer screening, human papillomavirus (HPV) vaccination, chlamydia screening, flu vaccination, HIV screening, and blood pressure screening among more than 700,000 female patients aged 11 to 65 accessing care in 354 community health centers in 14 states. Ten of the states had expanded Medicaid under the ACA, and the authors compared receipt of recommended preventive care in states that did and did not expand Medicaid.
Hatch and her colleagues found that receipt of all preventive services except for blood pressure screening increased after ACA implementation in both groups of states; flu vaccination and blood pressure screening increased more in expansion states, and chlamydia screening more in non-expansion states. They note that despite the improvements, receipt of most recommended services—except for blood pressure screening—remains low and indicates “the need for additional support of the CHC system to improve preventive service delivery to women and girls.”
The authors explained that the limitations of the electronic health records at the time of data collection resulted in a sample consisting solely of patients who selected “female” as their sex. “We strongly support improvement in clinic and data systems to collect more specific information about gender identity and believe that understanding the receipt of preventive care among individuals of diverse gender identities should be a priority for future research,” Hatch said.
“Community health centers are an essential source of care for women and girls who have low incomes and live in underserved areas,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “While it’s encouraging to see that the ACA has allowed them to provide preventive services to more patients, this study shows that we must do more to ensure all CHC patients can access comprehensive care.”
“Impacts of the Affordable Care Act on Receipt of Women’s Preventive Services in Community Health Centers in Medicaid Expansion and Nonexpansion States” has been published in the January/February 2021 issue of Women’s Health Issues. The paper is part of the Agency for Healthcare Research and Quality funded EVERYWOMAN study led by OCHIN, a national nonprofit health IT organization serving to advance health equity through technology, data insights, and expertise, in collaboration with the PCORI funded ADVANCE Clinical Research Network, an OCHIN-led partnership between Oregon Health & Science University, Health Choice Network, and Fenway Health.