Perhaps you recall some of the key findings and the call to action of last year’s Brookings report, “Charting Maine’s Future.” To be successfully positioned for future prosperity, Maine must: push innovation, embrace efforts to reduce spending and support sustainable prosperity and produce savings through efficient delivery of service.

In another report “Access Granted,” released earlier this week by the National Association of Community Health Centers and the Robert Graham Center, researchers found that medical expenses for Community Health Center patients are 41 percent lower compared to patients seen elsewhere. The lower costs are attributed to these health centers’ patient-centered care and high quality, both of which improve patient outcomes and reduce the reliance on overburdened emergency rooms.

Community Health Centers also produce these savings through efficient delivery of service. CHCs effectively co-locate multiple services in a single medical home, affording patients a one-stop shop for primary care, mental health, and, increasingly, dental care. For example, Maine’s CHCs have increased dental access by 450 percent over the last five years, eradicating wait lists for dental care in some areas of the state. Clearly there is more to be done given the unfortunate prevalence of dental disease in Maine, and health centers are continuing to respond to their community needs.

A significant contributing factor to CHC response to local needs is the CHC model itself: Community Health Centers are required to be governed by a patient-controlled board that is independent from outside influence and responsive to community health concerns. Established in locations serving medically underserved areas and populations, health centers provide access to expanded services for all patients. Moreover, health centers augment partnerships with area social service agencies and invest their own limited budgets to outreach, transportation and other types of health connector services. Last year, this investment was every one in $26 of health center revenue, an impressive commitment when considering that all told, Maine CHCs shouldered a statewide deficit of $2 million.

Despite the lack of any financial margin, Maine Community Health Centers lead efforts to reduce total health care spending and support sustainable prosperity. Maine health centers account for less than 1 percent of statewide health care spending, and yet provide access to care for 15 percent of the state’s populace, a number that has more than doubled in five years even while the percentage of total health care spending has remained constant.

Moreover, for every dollar invested in Maine CHCs, there are $3.05 in savings to MaineCare, and similar savings accrue to other payers as well, mostly through the avoidance of more expensive downstream costs. For instance, CHCs have been shown to reduce what should be avoidable hospitalizations by 22 percent. Yet we still have a ways to go in our state with more than $105 million in costs for avoidable trips to the emergency room.

Maine Community Health Centers also lead innovation in health care. In addition to the integrated medical home mentioned above, CHCs in Maine were the first in the state to adopt and apply the Planned Care Model. Now, all of Maine’s Community Health Centers are on track to have incorporated this patient-centered approach to high quality care within their practices by 2008. Furthermore, by the end of the year, 70 percent of CHCs will have instituted an electronic medical record within the primary care medical home, a wise use of available technology that increases clinician access to information, and reduces the opportunity for error by making patient information, lab results and medication history more accessible at the point and time of care.

The Brookings report finding that Maine spends 95 percent more on health care than the rural average is a testament to both the desire for high quality health care (Maine consistently ranks in the top three states for our quality of health care) and also the collective inefficient use of resources across Maine. As documented in “Access Granted,” CHCs are making great strides to increase the efficiency of service delivery while also further raising the quality of care. The challenge before us is to further develop the model to: build further upon the efficient integration of mental health in the Community Health Center setting; increase dental access further across the network of CHC medical homes and continue to target chronic disease prevention and effective treatment and provide care management services to patients with chronic ailments such as diabetes, cardiovascular disease, depression, cancer, respiratory disease and asthma.

We must also expand access to the patient-centered care of CHCs to even greater numbers of Maine residents – particularly those who otherwise would not have a medical home, whether or not they have coverage of some sort; work across health care settings – including hospitals and long term care facilities – to reduce readmission rates and inappropriate emergency room use; and invest further in patient self-management strategies that leverage the innate self-sufficiency and independence for which the people of Maine are famous.

This is a tall order, but a necessary one for us as a state to maintain our rightful insistence on high quality of care, while at the same time reducing our total health care costs through improved health and smarter utilization of well distributed and accessible services. Maine’s Community Health Centers provide just such a model.

Kevin Lewis is the executive director of the Maine Primary Care Association.