Community Health Centers Adapt to Increased Demand for Care

Centers Report Treating More Patients—Mainly Uninsured—Over Last Two Years

News Release
Dec. 19, 2007

Alwyn Cassil (202) 264-3484 or

WASHINGTON, DC—Despite significant federal funding increases, community health centers (CHCs)—the backbone of the nation’s safety net—are struggling to meet rising demand for care, particularly for specialty medical, dental and mental health services, according to a study released today by the Center for Studying Health System Change’s (HSC).

Since 2000, federal funding for federally qualified community health centers—key providers of preventive and primary care for underserved people—has doubled to nearly $2 billion annually in 2006, according to the Health Resources and Services Administration (HRSA). More than 16 million patients—primarily racial or ethnic minorities, low income, uninsured or covered by Medicaid—received care at more than 1,100 federally qualified and look-alike health centers in 2006, up from just more than 10 million patients in 2001, according to HRSA.

Much of the recent federal investment has gone to build health centers in additional communities, while support for existing CHCs has not kept pace with operating expense increases and patient growth. At the same time, according to the HSC study, recruiting and retaining staff members in a competitive labor market has grown more difficult, and CHCs are facing other demands, including increased quality reporting expectations, addressing racial and ethnic disparities, and preparing for public health emergencies.

"Community health centers are getting squeezed from both directions—on one side by rising numbers of uninsured people and on the other by a decline in other providers’ willingness to care for uninsured patients," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded primarily by the Robert Wood Johnson Foundation.

Charged with providing preventive and primary care, CHCs face growing problems referring uninsured and Medicaid patients—three out of four of their patients—for specialty care, according to the study.

"In the last decade, physician charity care has declined, and while most physicians still provide some charity care, demand far outstrips supply, particularly for specialty care," said HSC Senior Consulting Researcher Robert Hurley, Ph.D., of Virginia Commonwealth University, coauthor of the study with Laurie E. Felland, M.S., HSC health researcher, and Johanna Lauer, an HSC health research assistant.

The study’s findings are detailed in a new HSC Issue Brief—Community Health Centers Tackle Rising Demands and Expectations—is available here. The study is based on HSC’s 2007 site visits to 12 nationally representative communities: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y. HSC has been tracking change in these markets since 1996.

Other key study findings include:

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.