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Search peer-reviewed articles related to the Health Center Program, including those presented by HRSA authors and partner agencies, in four areas: Health Care Access, Quality, Cost, and Equity.

Contact: Submit inquiries about Health Center Program research to the BPHC Contact Form under Health Center Data and Research, Health Center Program Research.

The listed Topics for each article are not exhaustive. Please use the Keyword search bar to find a more comprehensive list of articles related to your topic of interest.

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1-25 of 52 Articles
Featured

Utilization, Quality, and Spending for Pediatric Medicaid Enrollees with Primary Care in Health Centers vs Non-Health Centers

Author(s): Anna Volerman, Bradley Carlson, Wen Wan, Manoradhan Murugesan, Nour Asfour, Joshua Bolton, Marshall H. Chin, Alek Sripipatana, and Robert S. Nocon
Journal: BMC Pediatrics
Publication Year: 2024
Topic: Federally Qualified Health Centers (FQHC); Medicaid; Cost of Care

What does this study add? HRSA-funded researchers found that on average, $240 are saved on total expenditures per pediatric health center patient compared to those receiving care at a non-health center. $300 per pediatric patient were saved on non-primary care outpatient spending, and $137 per pediatric patient were saved on pharmacy spending. Pediatric health center patients produced similar levels of emergency department spending, but for inpatient visits, $51 per pediatric health center patient were saved.  

What are the implications for the Health Center Program? Findings suggest that the delivery of primary care services at a health center may be associated with a more cost-effective model of healthcare for children. Overall, the findings of lower spending and comparable quality among health center patients underscore the importance of expanding such models of care that can optimize utilization, quality, and cost, especially for Medicaid populations.
 

Featured

Quantifying Population Characteristics Within and Outside a 30-Minute Drive-Time to Health Resources and Services Administration-Supported Health Centers

Author(s): Jennifer L Rankin, Jessica McCann, Michael Topmiller, Dave Grolling, Troyana Benjamin, Helen Yu-Lefler, Hank Hoang, Alek Sripipatana
Journal: The Journal of Ambulatory Care Management
Publication Year: 2024
Topic: Access; Federally Qualified Health Centers (FQHC); Telehealth

What does this study add? The study examined characteristics of populations living within and outside a 30-minute drive-time to HRSA-supported health centers. HRSA-funded researchers found that 94% of Americans live in a census tract categorized as being within a 30-minute drive-time of a health center service delivery site. Of those outside a 30-minute drive-time to a health center, 11.7 million (60.11%) are located in a rural area and over 1.5 million households (20.32%) lack broadband internet access.

What are the implications for the Health Center Program? While only 6% of people in the U.S. live outside a 30-minute drive time of a health center, studies show that living outside a 30-minute drive-time to a health care provider affects accessibility to nearly every form of health care. Research has found that provision of new health center service delivery sites, enabling services, and telehealth are associated with improved health care access to medically underserved communities.

Featured

Health Care Use and Spending for Medicaid Enrollees in Federally Qualified Health Centers Versus Other Primary Care Settings

Author(s): Robert S. Nocon, Sang Mee Lee, Ravi Sharma, Quyen Ngo-Metzger, Dana B. Mukamel, Yue Gao, Laura M. White, Leiyu Shi, Marshall H. Chin, Neda Laiteerapong, Elbert S. Huang
Journal: American Journal of Public Health
Publication Year: 2016
Topic: Federally Qualified Health Centers (FQHC); Cost of Care; Medicaid

What does this study add? HRSA-funded researchers utilized 2009 fee-for-service Medicaid claims from 13 states to compare the health care use and costs of Medicaid enrollees seen at health centers versus those seen in non-health center settings. The study found that Medicaid enrollees who received the majority of their primary care in health centers had lower total health care use and spending than patients who receive primary care in other settings. Total spending was 24% lower for health center patients.

What are the implications for the Health Center Program? These findings demonstrate the cost-efficiencies associated with federally qualified health centers. The results suggest an association between health center primary care setting and health care use and spending. Further examination of organizational characteristics is necessary to understand the relationship between primary care settings and utilization, cost, and quality of care.

 

Featured

Patient-Centered Medical Home Recognition and Clinical Performance in U.S. Community Health Centers

Author(s): Leiyu Shi, De-Chih Lee, Michelle Chung, Hailun Liang, Diana Lock, Alek Sripipatana
Journal: Health Services Research
Publication Year: 2016
Topic: Federally Qualified Health Centers (FQHC); Quality; Uniform Data System (UDS)

What does this study add? The study found health centers that achieved patient-centered medical home (PCMH) accreditation were associated with better clinical performance than those without PCMH recognition. Health centers with PCMH recognition performed better on 13 of the 16 Uniform Data System (UDS) clinical performance measures in 2012.

What are the implications for the Health Center Program? The findings demonstrate that the PCMH model should be leveraged to further enhance the quality of primary care. Future researcher should examine which components of the PCMH model are most associated with improved care performance, so that health centers can develop interventions that specifically address those components.
 

Featured

Cigarette Smoking, Desire to Quit, and Tobacco-Related Counseling Among Patients at Adult Health Centers

Author(s): Lydie A. Lebrun-Harris, Michael C. Fiore, Naomi Tomoyasu, Quyen Ngo-Metzger
Journal: American Journal of Public Health
Publication Year: 2015
Topic: Federally Qualified Health Centers (FQHC); Health Center Patient Survey (HCPS); Health Disparities

What does this study add? The study highlighted cigarette smoking prevalence, desire to quit, and tobacco-related counseling at health centers. Although smoking prevalence was found to be higher among patients at health centers (31%) than U.S. adults in general (21%), most smokers at health centers reported a desire to quit (83%), with uninsured patients more frequently reporting the desire to quit (89%). Data came from the 2009 Health Center Patient Survey and the 2009 National Health Interview Survey (NHIS).

What are the implications for the Health Center Program? Findings suggest that it is important for health centers to consider the patients’ economic context and provide additional supportive counseling and resources to encourage tobacco cessation. To best meet patients’ needs, health centers should continue efforts to address screening, counseling, and treatment of tobacco use. 

Featured

Comparing the Cost of Caring for Medicare Beneficiaries in Federally Funded Health Centers to Other Care Settings

Author(s): Dana B. Mukamel, Laura M. White, Robert S. Nocon, Elbert S. Huang, Ravi Sharma, Leiyu Shi, Quyen Ngo-Metzger
Journal: Health Services Research
Publication Year: 2015
Topic: Federally Qualified Health Centers (FQHC); Cost of Care; Medicaid

What does the study add? The study compared the annual costs for Medicare beneficiaries receiving care in federally funded health centers versus Medicare beneficiaries receiving primary care in other settings. HRSA-funded researchers found that total median annual costs for beneficiaries receiving care in health centers were 34% and 11% lower than those receiving care in outpatient clinics and physician offices, respectively. While the study also found that health center patients incurred higher primary care costs, their nonprimary care costs were lower.

What are the implications for the Health Center Program? The findings indicate that beneficiaries who access care at a health center would save Medicare about 10% on costs per beneficiary compared to physician office practices and about 30% compared to outpatient clinic practices. Future research might investigate the nonprimary care cost-savings associated with Medicare beneficiaries seeking care at health centers. 
 

Featured

Health Center Patients’ Insurance Status and Healthcare Use Prior to Implementation of the Affordable Care Act

Journal: American Journal of Preventative Medicine
Publication Year: 2015
Topic: Access; Cost of Care; Health Center Patient Survey (HCPS)

What does this study add? The study examined patterns of health center use by patient health insurance status (private, public, none) prior to implementation of the Affordable Care Act (ACA). By analyzing national data from the 2009 Health Center Patient Survey, the study found that insured patients used health centers for the majority of their care in similar proportions to their uninsured counterparts. However, groups differed in their motivations for seeking care at a health center; uninsured patients highlighted affordability as the main reason for visiting a health center, whereas insured patients emphasized convenience of health center location and quality of care.

What are the implications for the Health Center Program? The findings suggest that patients use health centers for the majority of their care regardless of insurance status. Future studies might examine the impact of the ACA’s insurance coverage expansions on patients’ use of health centers for their primary care. 
 

Featured

Access to Mental Health Services Among Patients at Health Centers and Factors Associated with Unmet Needs

Author(s): Emily Jones, Lydie A. Lebrun-Harris, Alek Sripipatana, Quyen Ngo-Metzger
Journal: Journal of Health Care for the Poor and Underserved
Publication Year: 2014
Topic: Access; Mental Health; Health Center Patient Survey (HCPS)

What does this study add? The study explored the mental health needs of health center patients, the utilization of mental health services, and factors associated with unmet need for mental health services by analyzing the 2009 Health Center Patient Survey. Researchers found that one in five adult health center patients accessed mental health services. Still, one in three patients reported unmet needs for mental health care. 39% of those patients reporting unmet needs for mental health care cited affordability was the top reason for unmet needs.

What are the implications for the Health Center Program? Patients who lack a usual source of care and those with severe mental illness were the most likely to experience unmet mental health care needs. Further research on the mechanisms driving unmet need for mental health services should be explored as well as the barriers that prevent individuals from receiving adequate mental health treatment.

Differences in Health Care Utilization of High Need and High Cost Patients of Federally Funded Health Centers Versus Other Primary Care Providers

Author(s): Nadereh Pourat, Xiao Chen, Connie Lu, Weihao Zhou, Helen Yu-Lefler, Troyana Benjamin, Hank Hoang, Alek Sripipatana
Journal: Medical Care
Publication Year: 2024
Topic: Access; Cost of Care; Federally Qualified Health Centers (FQHC); Medicaid; Primary Care

What does this study add? The study highlights differences in health care utilization among high-cost, high-need Medicaid beneficiaries who receive primary health care at health centers versus other primary care settings. Patients of HRSA-funded health centers received equal or more primary care compared to their non-health center counterparts while also having fewer specialty care, emergency room, and hospital visits.

What are the implications for the Health Center Program? The Health Center Program has the potential to reduce costly healthcare burden among high-cost, high need Medicaid beneficiaries through high quality care.

Health Centers and Social Determinants of Health: An Analysis of Enabling Services Provision and Clinical Quality

Author(s): Michael Topmiller, Jessica McCann, Hank Hoang, Jennifer Rankin, Jene Grandmont, Molly Pelzer, Alek Sripipatana
Journal: Family Medicine and Community Health
Publication Year: 2023
Topic: Access; Federally Qualified Health Centers (FQHC); Primary Care; Quality; Uniform Data System (UDS)

What does this study add? The researchers found health centers that provided the most enabling services performed better on nine of ten clinical quality process measures. However, these health centers had more patients with uncontrolled high blood pressure and diabetes.

What are the implications for the Health Center Program? These findings suggest enabling services may have a stronger positive correlation with clinical quality process measures than outcome measures. However, it is unlikely that enabling services have a detrimental effect on outcome measures, and it is more plausible that enabling services are unable to independently address certain poor health outcomes. Enabling services are intended to increase access to care, which is an example of a process measure, while other factors contribute to final health outcomes throughout the continuum of care. Even so, better clinical process performance shows that these services might mitigate some effects of social risk factors.

Staffing transformation following Patient-Centered Medical Home recognition among Health Resources & Services Administration-funded health centers

Author(s): Nadereh Pourat, Connie Lu, Xiao Chen, Weihao Zhou, Brionna Hair, Joshua Bolton, Hank Hoang, Alek Sripipatana
Journal: Health Care Management Review
Publication Year: 2023
Topic: Primary Care; Federally Qualified Health Centers (FQHC)

What does this study add? The study examined whether Patient-Centered Medical Home (PCMH) recognition promoted health center staffing structures that were more team-based and integrated by assessing growth of multidisciplinary medical or non-medical providers per primary care physicians (team-based ratio) and per 2,000 patients (colocation ratio). Researchers found that among three cohorts of health centers that received PCMH recognition in 2013, 2014, and 2015, all three had significantly larger colocation ratios after PCMH adoption. Additionally, 2013 and 2014 adopters of PCMH had significant increases in team-based ratios.  
 
What are the implications for the Health Center Program? These research findings indicate progress by HRSA-funded health centers to provide team-based care and integrated care delivery and the potential role of PCMH recognition in promoting transformational change. 

Weight management practices of health center providers in the United States

Author(s): Nadereh Pourat, Connie Lu, Xiao Chen, Weihao Zhou, Hank Hoang, Alek Sripipatana
Journal: Journal of Communication in Healthcare
Publication Year: 2023
Topic: Health Center Patient Survey (HCPS); Primary Care; Quality; Federally Qualified Health Centers (FQHC)

What does this study add? The study examined associations between weight management practices at HRSA-funded health centers and selected health outcomes. The researchers determined a greater proportion of patients who are obese reported receiving provider interventions compared to overweight patients, and patients who received a provider diagnosis of weight as a problem and/or recommendations to change their diet had better odds of improved health status.
 
What are the implications for public health practice? These findings demonstrate the importance of provider weight management interventions in improving patient health outcomes and the need for more consistent interventions across patients who are obese and overweight. Providers should continue to engage motivational interviewing techniques, initiate culturally appropriate discussions about weight, and work to address social determinants of health like lack of safe spaces for exercise and availability of healthy nutrition. 

Factors associated with frequent emergency department visits among health centre patients receiving primary care

Author(s): Nadereh Pourat, Connie Lu, Xiao Chen, Weihao Zhou, Brionna Hair, Joshua Bolton, Hank Hoang, Alek Sripipatana
Journal: Journal of Evaluation in Clinical Practice
Publication Year: 2023
Topic: Cost of Care; Equity; Federally Qualified Health Centers (FQHC)

What does this study add? Patients who used health centers as their usual source of care for three or more years visited the emergency department less often than patients who used health centers for less than three years. Overall, the study explored how patient experiences and care management approaches at health centers might affect how often patients visit the emergency department by analyzing 2014 Health Center Patient Survey (HCPS) data and 2014 Uniform Data System (UDS) data.

What are the implications for the Health Center Program? The findings suggest that patients who regularly access primary care at health centers make fewer visits to the emergency department in the long term. This means upfront costs for primary care may help avoid larger downstream costs. Other HRSA-funded research, such as this article on care for patients with Medicaid coverage and opioid use disorder, also finds that health centers may reduce overall spending on health care.

Early experience of the Quality Improvement Award program in federally funded health centers

Author(s): Janel L Jin, Joshua Bolton, Robert S Nocon, Elbert S Huang, Hank Hoang, Alek Sripipatana, Marshall H Chin
Journal: Health Services Research
Publication Year: 2022
Topic: Cost of Care; Federally Qualified Health Centers (FQHC); Quality

What does this study add? HRSA-funded researchers analyzed associations between health center characteristics and receipt of Quality Improvement Awards (QIA) from 2014-2018. Researchers found that almost all participating health centers (99.7%) received at least one QIA during the study period, and health centers with Electronic Health Record (EHR) reporting and Patient-Centered Medical Home (PCMH) recognition earned higher award funding even after excluding bonus payments for these two capacities.

What are the implications for the Health Center Program? Although the QIA program has since evolved into other value-based funding mechanisms, the findings suggest that investments in EHR and PCMH accreditation may have supported broader clinical quality improvement and that health centers are able to implement value-based payment initiatives to improve patient experiences and health outcomes. The findings also suggest that HRSA award programs should set clinical quality benchmarks ahead of time.

Estimating the Impact of Medicaid Expansion and Federal Funding Cuts on FQHC Staffing and Patient Capacity

Author(s): Shiyin Jiao, R Tamara Konetzka, Harold A Pollack, Elbert S Huang
Journal: Milbank Quarterly
Publication Year: 2022
Topic: Cost of Care; Federally Qualified Health Centers (FQHC); Medicaid

What does this study add? To estimate the impact of changes in revenue, HRSA-funded researchers simulated funding changes using statistical models that estimated the number of full-time equivalent staff (FTEs), number of patients served, and number of visits as outcomes of Medicaid revenue, Section 330 grant funding, other revenue, patient characteristics, and county-level characteristics.

What are the implications for the Health Center Program? HRSA-funded health centers could support care to over 2,000 additional patients with an increase of $1 million dollars in grants provided under Section 330 of the Public Health Service Act.

Disparities in Smoking Prevalence and Associations with Mental Health and Substance Use Disorders in Underserved Communities across the U.S.

Author(s): Sue C Lin, Naomie Gathua, Cheryl Thompson, Alek Sripipatana, Laura Makaroff
Journal: Cancer
Publication Year: 2022
Topic: Cancer; Mental Health; Substance Use; Federally Qualified Health Centers (FQHC)

What does this study add? HRSA-funded researchers examined the relationship between smoking, mental health conditions and substance use disorders among adult patients served by HRSA-funded health centers. Using data from HRSA’s 2014 Health Center Patient Survey (HCPS), researchers found that smoking prevalence among adult health center patients is twice as high as the general U.S. population and is associated with mental health conditions and substance use disorders. 

What are the implications for the Health Center Program? Study results suggest that health center patients most benefit from smoking cessation interventions that are integrated into routine primary care and delivered in a patient-centered care environment that promotes open communication and shared decision making.  Results highlight the important role health centers play in providing tobacco cessation interventions tailored to the needs of underserved communities.

The Relative Contribution of Social Determinants of Health Among Health Resources and Services Administration-Funded Health Centers

Author(s): Nadereh Pourat, Ziao Chen, Connie Lu, Weihao Zhou, Brionna Y Hair, Joshua Bolton, Alek Sripipatana
Journal: Population Health Management
Publication Year: 2022
Topic: Health Disparities; Federally Qualified Health Centers (FQHC)

What does this study add? HRSA-funded researchers found that, among five social determinant of health (SDOH) indicator categories, health care access and utilization had the largest relative contribution to self-reported fair or poor health and diagnoses of diabetes, hypertension, cardiovascular disease, and depression or anxiety. The relative contributions of the other SDOH indicator categories (i.e., health behaviors, social factors, economic factors, quality of care, and physical environment) varied by each health status measure.

What are the implications for the Health Center Program? The study highlights how health centers can prioritize which SDOH to target for interventions based on patients’ specific health conditions. An improved understanding of which SDOH most strongly influence their patients’ health outcomes can help health centers develop proactive and appropriate interventions. 

Health care use and spending for Medicaid patients diagnosed with opioid use disorder receiving primary care in Federally Qualified Health Centers and other primary care settings

Author(s): Lauren Peterson, Manoradhan Murugesan, Robert Nocon, Hank Hoang, Joshua Bolton, Naida Laiteerapong, Harold Pollack, Jeanne Marsh
Journal: PLoS ONE
Publication Year: 2022
Topic: Medicaid; Federally Qualified Health Centers (FQHC)

What does this study add? HRSA-funded researchers found that primary care utilization and spending were higher for health center patients with Medicaid insurance who have been diagnosed with opioid use disorder compared to similar patients in other settings, but total healthcare costs were lower. The researchers determined that health center patients were more likely to receive timely behavioral health therapy and less likely to fill inappropriate co-prescriptions, demonstrating the strength of holistic and coordinated care in the Health Center Program. However, health center patients were less likely to receive timely Medication-Assisted Treatment (MAT), which may be partly attributed to the availability of providers with MAT waivers at the time of this study.

What are the implications for the Health Center Program? Health centers are uniquely positioned to provide integrated primary and behavioral health care to medically underserved populations. 

Quality of Care for US Adults with Medicaid Insurance and Type 2 Diabetes in Federally Qualified Health Centers Compared with Other Primary Care Settings

Author(s): Alexandra C Knitter, Manoradhan Murugsan, Loren Saulsberry, Wen Wan, Robert S Nocon, Elbert S Huang, Joshua Bolton, Marshall H Chin, Neda Laiteerapong
Journal: Medical Care
Publication Year: 2022
Topic: Medicaid; Federally Qualified Health Centers (FQHC)

What does this study add? HRSA-funded researchers identified innovative and effective approaches to improve diabetes care for Medicaid enrollees in health center primary care settings. 

What are the implications for the Health Center Program? The key takeaway from this research is that a higher proportion of patients receive diabetes care at HRSA-funded health centers and that health centers are an important primary care practice setting for diabetes care. Additionally, compared to diabetes care in other primary care settings, diabetes patients at health centers received diabetes education more regularly, have a lower rate of hospitalizations, a higher rate of emergency department visits, and lower rates of laboratory-based tests for diabetes. 

Factors Associated with Federally Qualified Health Center Financial Performance

Author(s): Daniel Jung, Elbert S. Huang, Eric Mayeda, Rachel Tobey, Eric Turer, James Maxwell, Allison Coleman, Jennifer Saber, Susan Petrie, Joshua Bolton, Daniel Duplantier, Hank Hoang, Alek Sripipatana, Robert Nocon
Journal: Health Services Research
Publication Year: 2022
Topic: Federally Qualified Health Centers (FQHC); Medicaid; Uniform Data System (UDS)

What does this study add? To better understand drivers of financial stability, HRSA researchers collaborated with the University of Chicago to review six measures of health center financial performance that provide insight into health centers’ long-term financial health. The researchers found that higher proportions of Medicaid patients and non-physician healthcare providers (e.g., nurse practitioners, physician assistants, etc.) have positive associations with a health center’s financial sustainability. Patient-Centered Medical Home (PCMH) recognition was also associated with better financial health.

What are the implications for the Health Center Program? Ensuring that health centers remain in good financial health is essential to avoid the risk that these organizations close their doors or reduce vital scope of services. 

Health Centers and Value-Based Payment: A Framework for Health Center Payment Reform and Early Experiences in Medicaid Value-Based Payment in Seven States

Author(s): Rachel Tobey, James Maxwell, Eric Turer, Erin Singer, Zoe Lindenfeld, Robert S. Nocon, Allison Coleman, Joshua Bolton, Hank Hoang, Alek Sripipatana, Elbert S. Huang
Journal: The Milbank Quarterly
Publication Year: 2022
Topic: Cost of Care; Medicaid; Quality; Federally Qualified Health Centers (FQHC)

What does this study add? This study assessed health center value-based payment (VBP) participation in seven states and found increased participation over time as well as associations with improved health center financial outcomes. Researchers found that in these seven states VBP participation grew from 35% to 58% from 2013 to 2017. During the same time period, health centers increasingly participated in more advanced payment models, which allowed them to improve care coordination and quality and cost outcomes.

What are the implications for the Health Center Program? To increase health center patient participation in VBP, research findings highlight the importance of financial incentives from Medicaid agencies and Medicaid managed plans as well as health center-Medicaid collaboration under strong Primary Care Association (PCA) and health center leadership. 

Ensuring Equitable Care in Diabetes Management Among Patients of Health Resources & Services Administration–Funded Health Centers in the United States

Author(s): Nadereh Pourat, Xiao Chen, Connie Lu, Weihao Zhou, Brionna Hair, Joshua Bolton, Alek Sripipatana
Journal: Diabetes Spectrum
Publication Year: 2022
Topic: Equity; Health Disparities; Federally Qualified Health Centers (FQHC)

What does this study add? HRSA-funded researchers found that health centers provide equitable diabetes care, including HbA1c testing and eye exams, and advance racial/ethnic parity in diabetes-specific outcomes. Researchers also identified opportunities to further advance health equity by improving foot exams, individual treatment plans, and cholesterol checks for racial and ethnic minority patients.

What are the implications for the Health Center Program? Findings suggest that health centers are uniquely positioned to advance equity in access and quality in care. This study highlights opportunities for health centers to scale more tailored diabetes care management approaches that are culturally competent and facilitate equitable access to diabetes management services such as individual treatment plans and cholesterol checks. 

A Systematic Literature Review of Health Center Efforts to Address Social Determinants of Health

Author(s): Nadereh Pourat, Connie Lu, Denisse M. Huerta, Brionna Y. Hair, Hank Hoang, Alek Sripipatana
Journal: Medical Care Research and Review
Publication Year: 2022
Topic: Equity; Health Disparities; Health Information Technology (HIT); Federally Qualified Health Centers (FQHC)

What does this study add? Health centers play an integral role in addressing social determinants of health (SDOH) among medically underserved populations, yet information on how health centers utilize SDOH data to inform care is limited. HRSA-funded researchers conducted a systematic review to understand how health centers integrate SDOH into primary care practices. Researchers found that many health centers are making progress on collecting SDOH data using standardized reporting tools and other initiatives, but they may require more support to use the data in primary care practices and program evaluation efforts.

What are the implications for the Health Center Program? Health care delivery models that emphasize accountability for patient outcomes should support initiatives for primary care providers to integrate SDOH data in efforts to improve care quality and outcomes.

Trends in access to care among rural patients served at HRSA-funded health centers

Author(s): Nadereh Pourat, Connie Lu, Xiao Chen, Weihao Zhou, Brionna Hair, Joshua Bolton, Alek Sripipatana
Journal: The Journal of Rural Health
Publication Year: 2022
Topic: Federally Qualified Health Centers (FQHC); Primary Care

What does this study add? Rural health center patients reported lower unmet and delayed medical care according to an analysis comparing Health Center Patient Survey (HCPS) data from 2009 and 2014. The study also showed that patients reported steady access to mental health care but a decrease in Pap tests and mammogram screenings during the same period.  

What are the implications for the Health Center Program? Although other HRSA-funded research suggests that performance is on par between urban and rural health centers, understanding barriers to providing timely and accessible preventive services to rural health center patients remains critical. Key areas for future policy and practice include improving multi-disciplinary management of patient care, supporting additional research about the barriers to access of preventive and primary care services, and investing in infrastructure improvements in rural areas to promote connectivity.  

Intersection of Complexity and High Utilization Among Health Center Patients Aged 18 to 64 Years

Author(s): Nadereh Pourat, Xiao Chen, Yusuke Tsugawa, Connie Lu, Weihao Zhou, Hank Hoang, Brionna Hair, Joshua Bolton, Alek Sripipatana
Journal: American Journal of Managed Care
Publication Year: 2021
Topic: Cost of Care; Primary Care; Mental Health; Federally Qualified Health Centers (FQHC)

What does this study add? The study identified health center patients with complex health conditions who are high health care utilizers. The researchers categorized patients as those with mental health conditions (32%), multiple chronic conditions (27%), or low risk (41%). The researchers also categorized patients as low utilizers (73%), high utilizers (24%), and super high utilizers (3%). The findings determined high and super high utilizers with mental health conditions often had comorbid conditions of obesity, smoking, hypertension and cardiovascular disease.

What are the implications for the Health Center Program? These results indicate that concurrent mental health and physical chronic conditions are major drivers of high health care system utilization. The findings highlight the importance of primary and mental health care coordination and the Patient-Centered Medical Home (PCMH) model to meet the needs of health center patients with complex conditions.