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Health Center Program: Impact and Growth

For more than 55 years, health centers have delivered affordable, accessible, quality, and value-based primary health care to millions of people regardless of their ability to pay. Health centers serve 1 in 11 people across the country, and they lead the nation in driving quality improvement and reducing health care costs for America’s taxpayers. Health centers provide high quality primary care services and support public health priorities such as the opioid crisis, the White House Ending the HIV Epidemic: A Plan for America initiative, and the response to COVID-19.

Providing Value-Based Care to Millions Across the Nation

HRSA’s investments have advanced the nation’s health by ensuring more patients and communities each year have access to high quality, comprehensive primary care. Today, HRSA funds nearly 1,400 health centers with more than 13,500 service delivery sites in every U.S. state, U.S. territory, and the District of Columbia. In 2020, more than 255,000 full-time staff served nearly 29 million patients. Health centers have nearly tripled the number of patients served since 2000.

Driving Quality Improvement

HRSA’s quality improvement investments advance a model of coordinated, comprehensive, and patient-centered care, integrating medical, dental, behavioral health, substance use disorder, and patient services.

These investments have positioned 1,058 health centers (77%) to achieve Patient-Centered Medical Home (PCMH) recognition. The PCMH model of care enables health centers to have strong patient outcomes at lower costs despite treating a sicker and poorer population in comparison with other health care settings.

Despite the significant challenges COVID-19 has placed on health center staff and operations, health centers have remained committed to providing high-quality, essential primary health care services to the nation’s underserved and vulnerable populations. In fact, 79% of health centers met or exceeded one or more national clinical benchmarks in 2020, with more than half (55%) reporting improvements in 5 or more clinical quality measures (CQMs), and 1 in 6 health centers nationwide (16%) reporting improvements in 8 or more CQMs.

Besides better patient outcomes, the health center model of care decreases the use of costly care choices, such as visits to emergency departments and hospitals.1 Health center patients also had 24% lower spending compared to non-health center patients across all services provided.2

Health Centers and COVID-19 Testing, Treatment, and Vaccination

Health centers have played a vital role during the COVID-19 public health emergency, providing testing, treatment, and vaccination services for the nation’s most underserved and vulnerable populations. Since the beginning of the COVID-19 pandemic, health centers rose to each new challenge, rapidly adapting to provide COVID-19 services while continuing to deliver quality primary health care services to their communities. In 2020, with limitations on non-essential travel and in-person services, both rural and urban health centers across the nation quickly adapted to the needs of their patients, with practically all offering virtual primary health care services. Health centers provided over 28.5 million virtual visits, approximately 6,000% more than in 2019.

Health centers have also provided invaluable data through surveys that collect information on their testing and vaccination activities and the impact of COVID-19 on their operations. Cumulative survey data are available via interactive dashboards for COVID-19 testing and vaccinations, as well as health center operations.

Between the start of the pandemic and the end of fiscal year 2021, HRSA will have awarded approximately $9.3 billion in new funding to support Health Center Program grantees and look-alikes in responding to COVID-19. This funding has enabled health centers to keep or increase their staffing levels, conduct trainings, buy personal protective equipment, enhance health care services and infrastructure, and administer tens of millions of tests and vaccines.

Health centers have been at the forefront of the Administration’s efforts to ensure equity in COVID-19 vaccine distribution. Beginning in February 2021, HRSA and CDC launched the Health Center COVID-19 Vaccine Program to provide a direct supply of COVID-19 vaccines to health centers. This program has resulted in millions of vaccine doses being delivered to health centers across the country, with approximately three-quarters going to racial and ethnic minority patients.

Addressing Other Emergent Public Health Needs

Health centers are the first line of care in combatting the nation’s opioid crisis. In 2020, health centers provided substance use disorder services for nearly 300,000 patients and provided medication-assisted treatment (MAT) to nearly 182,000 patients nationwide, an increase of 366% since 2016. In 2020, 97% of health centers provided mental health counseling and treatment and 77% offered substance use disorder services.

HRSA-funded health centers are also an essential component of the Ending the HIV Epidemic in the U.S. initiative, serving a leading role in helping to diagnose, treat, prevent, and respond to HIV to end the epidemic. In 2020, health centers had 2.4 million visits for HIV tests and provided more than 389,000 people with access to PrEP.

1 Laiteerapong, Neda et al. “Health Care Utilization and Receipt of Preventive Care for Patients Seen at Federally Funded Health Centers Compared to Other Sites of Primary Care.” Health Services Research 49.5 (2014): 1498-1518.

2 Nocon, Robert S. et al. “Health Care Use and Spending for Medicaid Enrollees in Federally Qualified Health Centers Versus Other Primary Care Settings.” American Journal of Public Health 106.11 (Nov 2016): 1981-1989.

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