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alty that will increase each year. Over time, it should dramatically decrease the number of uninsured Americans — affecting a clinic whose mission was to serve the uninsured. Faced with an uncertain future, the free clinic chose a different route. “As a free clinic only serving the uninsured, the model was not sustainable, nor appropriate for meeting the health-care needs of the population post-national health-care reform,” Brauns wrote about the decision. The clinic’s board decided that becoming a community health center “was the optimal pathway into the future and the most secure way to meet the evolving needs of our target population during and after health-care reform.” In December 2013, the clinic closed its doors, only to reopen two weeks later with the new name and business model. The U.S. Health Resources Brauns and Services Administration (HRSA) designated it a community health center, along with a $733,000 grant. The grant amount will decrease to $650,000 next year, where it will remain so long as the clinic remains a community health center, Those funds account for about a third of the center’s budget. The shift “allows us to stay true to the uninsured,” says Brauns. “Community health centers do not deny anyone primary health care. Unlike a private family practice, [which] can make determinations about what type of patients it will see — often you’ll hear a doctor not taking any more Medicaid patients — we don’t deny care to anyone at any time.” The center uses a sliding fee scale for patients, with charges as low as $25. It also works with patients to establish payment plans if they can’t pay out of pocket. Since this is the first year of the healthPhoto by Alisa Moody

The number of patients visiting the Community Health Center of the New River Valley increased 116 percent in the first half of 2014.

care mandate, with a relatively minor penalty, it’s too soon to tell how it will ultimately affect the mix of patients at the new community health center. Since January, the number of individual patients seen at the center rose 116 percent through the first half of the year, with a similar increase in the number of patient visits. “I wouldn’t say we’ve seen

dramatic changes,” Brauns says. “We’ve seen a steady change in the addition of patients who have insurance. That was one of our goals.” The clinic also saw a similar increase in the number insured through the federal marketplace. Additionally, the clinic has four employees who are certified as application counselors to help people seeking insurance. ROANOKE BUSINESS


Roanoke Business- Nov. 2014