The Growing Role of Community Health Centers in Primary Care

Federally supported community health centers (CHC) have been providing high quality primary care services to patients, regardless of a patient's ability to pay, for more than 50 years now.  Found in every U.S. state and territory, CHC's provide medically underserved communities with integrated primary care healthcare, including care for medical, dental, vision, behavioral health and substance use disorders.  In 2019, approximately 1,400 community health centers, operating through almost 13,000 delivery sites and engaging more than 252,000 full-time healthcare providers and staff,  served the primary care needs of nearly 30 million patients.  So last year 1 out of 11 (9%) Americans relied on federally supported community health centers for their primary care needs.

Taking a deeper dive into the numbers, the Health Resources and Services Administration (HRSA), the unit of the U.S. Department of Health and Human Service that oversees CHC programs across the country, reports that in 2019 CHCs served:

• 1 out of every 8 children in the U.S.
• 1 out of every 5 rural residents
• 1 out of every 5 Medicaid recipients
• 1 out of every 3 Americans living in poverty
• more than 398,000 military veterans
• more than 1.4 million U.S. agricultural workers
• more than 1.4 million U.S. homeless; and
• more than 885,000 children through school-based health centers

Given the scale and scope of services they provide, CHCs also play an important public health role in the U.S. healthcare system.  CHCs are critical providers in the screening and treatment of individual living with substance use disorders, HIV and, more recently, COVID-19.  In 2019, CHCs screened nearly 1.4 million people for substance use disorders and 2.2 million patients for HIV. 

The role of CHCs in the U.S. healthcare system has been steadily increasing over the years.  In 2009, the year before the enactment of the Affordable Care Act (ACA), CHCs served 18.8 million patients according to the HRSA, nearly double their patient volume of 9.6 million patients in the year 2000.  Enactment of the ACA provided a further boost to CHC growth in two main ways.  First, it expanded Medicaid and private insurance, thereby improving the revenue model for CHCs.  Second, the ACA allowed for increased federal investment in the CHC program which, in turn, has led to the formation of more CHCs and expanded capacity to serve the public.  

From serving about 3.5% of the U.S. population in 2000, to serving 9% of the U.S. population in 2019, the role and importance of federally supported community health centers has never been more significant.  With some research estimating pandemic-related job losses resulting in over 7 million people losing employer-based health insurance, another 4 million more people shifting to Medicaid or the Children’s Health Insurance Programs (CHIP) for insurance coverage, and almost 3 million people becoming uninsured, the importance of CHC primary care services has never been greater.  

To learn more about federally supported community health centers, visit the HRSA.

To find federally qualified health centers in your community, use the locator tool below: