How Do Community Health Centers Work?

The nation’s first community health center debuted in 1965, and since then the federally qualified health center system has expanded to over 1,400 organizations — offering affordable health care options to more than 29 million people.

What is a community health center?

Community health centers (CHCs) are care facilities whose goal is increasing access to crucial primary and preventative care services. The primary demographic of these health centers is patients from lower income areas, who may be uninsured or underinsured, lack access to transportation, or face language barriers.

Examples of community health services include:

• Delivering high quality and comprehensive primary and preventative care regardless of patients’ ability to pay
• Offering supportive services such as health education, language translation, and transportation
• Operating under the direction of patient-driven boards of community-based organizations, including public and private non-profit organizations and tribal- and faith-based organizations
• Developing and providing systems that respond to the unique needs of diverse, underserved areas and populations
• Meeting compliance standards as described by the Health Resources and Services Administration’s (HRSA) Bureau of Primary Health Care (BPHC)

How are community health centers funded?

Medicaid is the largest source of funding for community health centers. Health centers operating within Medicaid expansion states have reported greater operational capacities and serve more patients than health centers in non-expansion states.

The remaining majority of funding for community health centers comes from the Health Center Program — authorized within the Public Health Services Act enacted July 1, 1944. Health Center Program funding is based on a combination of discretionary funding provided by Congress each year and mandatory funding from the Community Health Center Fund (CHCF), which accounts for 72 percent of all health center grant funds.

How are health centers impacting underserved communities?

According to data published by HRSA regarding health center performance, 62.89 percent of health center patients in 2018 were of an ethnic minority. Almost 50 percent of patients were covered by Medicaid and just under a quarter of patients were uninsured. Health centers play a critical role in the U.S. healthcare system by providing essential care to the communities that need it most.

Top 10 federally-qualified health centers by total number of visits

Fig 1: Data from Definitive Healthcare's Health Clinics Database using the Federally Qualified Health Centers Report Builder as of March 2020.

Definitive Healthcare data shows that health center patient volume is closely related to both state population and cost of living. The above chart shows which federally qualified health center clinics have the highest reported visits. The majority of ranking facilities are in California, with a few in Florida and one in New York. These three states have some of the highest populations in the U.S. Interestingly, TX has the second highest population by state, but no Texas health centers made this list, implying that cost of living also has an effect on health center use.

Learn more

Want to know more about community health centers? Read our blog Community Health Centers Show Billions in Medicare Savings for more health center content based on extensive relevant database queries.