In North Carolina, exploring whether to expand Medicaid took up a great deal of time and thought, but the General Assembly has voted against it, and the governor signed the bill to prevent it.

At Piedmont Health, a federally qualified health center for more than 40 years, we believe that not only is necessity the mother of invention, but fiscal challenge is the father of creativity.

Recently, the director of the state’s Medicaid program, Carol Steckel, was quoted as saying, “There are other alternatives besides the emergency room that low-income people can go to ... they’re called federally qualified health centers.”

Steckel was on target when she pointed to FQHCs as a viable option, and she showed her understanding of the health care system by mentioning the need for primary care.

As CEO of a nonprofit organization that operates six health centers in Central North Carolina, I know firsthand that these centers provide high-quality care at an affordable price. But you don’t have to take my word for it. The School of Public Health at George Washington University in Washington has extensively studied the role of FQHCs.

A 2011 report by the university concluded: “Our findings indicate that patients served by North Carolina’s health centers cost an average of 62 percent less annually across all types of care than do patients with the same health status and demographic characteristics served in other ambulatory care settings.” The centers saved more than $3,400 per patient in annual medical costs in the state, the study found.

The centers also provide jobs. According to a study by Capital Link, Piedmont Health generated 236 full-time jobs and injected almost $24 million directly into the local economy in 2009.

FQHCs provide quality care at a much lower cost by being innovative and aggressive in keeping costs down.

We operate a Program for All-Inclusive Care for the Elderly in Burlington. This program keeps seniors in their homes, where care is less expensive than in nursing homes. It also operates under a reimbursement formula that caps Medicaid costs. This saves taxpayers money.

Last year, we launched the Family Medicine Residency Program, a partnership with the UNC School of Medicine that will boost medical care in a rural part of Caswell County. This program controls costs in two ways: It is less expensive to train residents in a community setting than in a hospital, and a greater supply of doctors in rural areas keeps medical costs down in those areas.

We bill Medicaid $17, on average, for a prescription. This contrasts to a state average of $77 for other providers. We can do this by keeping our inventories down and by using generic drugs as much as possible.

Federally qualified health centers are not the only answer, but they are part of the solution. We provide the right care at the right time at the right cost.

Brian Toomey is the CEO of Piedmont Health, a Federally Qualified Health Center serving Central North Carolina.