The Pulse

Federally Qualified Health Centers And Their Importance

Written by Ayan Monpara, MD

November 10, 2020

IN A NUTSHELL:

Federally Qualified Health Centers crucial for millions of people
Elderly, poor, and uninsured rely on the centers
Important during a public health crisis

A Federally Qualified Health Center is a community-based health care provider that receive funds from the Health Resources and Services Administration (HRSA) Health Center Program to provide primary care services in underserved areas.

Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Health Centers for Residents of Public Housing could all fall under the umbrella of what is considered to be a Federally Qualified Health Center.

In the mid 1960s, the Columbia Point Health Center in Dorchester became the first of more than 1,000 FQHCs across the country that now serve more than 29 million people in approximately 12,000 communities across the country.

According to the HRSA, facilities must meet the following criteria to be considered a Federally Qualified Health Center:

Qualify for funding under Section 330 of the Public Health Service Act (PHS).
Qualify for enhanced reimbursement from Medicare and Medicaid as well as other benefits
Serve an underserved area or population
Offer a sliding fee scale
Provide comprehensive services (either on-site or by arrangement with another provider), including:
- Preventive health services
- Dental services
- Mental health and substance abuse services
- Transportation services necessary for adequate patient care
- Hospital and specialty care
Have an ongoing quality assurance program
Have a governing board of directors

Importance of Federally Qualified Health Centers

Federally Qualified Health Centers are important as they provide health care for patients that need it most, whether it be in underserved areas such as rural America or for low-income areas where patients might not otherwise be able to afford the care they need. These centers have been the backbone of the health care system for the economically disadvantaged in both urban and rural areas. They help provide health care to people that have no insurance. And they provide Medicare beneficiaries with crucial, preventive primary health services such as immunizations, visual acuity and hearing screenings.

While many Americans might be focused on the cost of their own health care, insurance premiums, or concerned about government mandates impacting their health plans, it is safe to bet that a majority also might not know much about the system that has been trying to improve the health of underserved populations for more than half of a century.

Impact of Federally Qualified Health Centers on Health Care Access

The importance and value of Federally Qualified Health Centers is clear, so let’s take a dive into how they impact health care.

Primarily, it is the impact of these centers on access to health care for underserved populations that is the most significant. According to the HRSA, nearly 30 million people, which is approximately 1 in 11 people in the United States rely on Federally Qualified Health Centers for care.

How Federally Qualified Health Centers Assist During a Public Health Crisis:

COVID-19 Pandemic:

Federally Qualified Health Centers are also important beyond traditional, everyday and preventative care. These centers are vital to help meet the nation’s emerging health priorities. During the COVID-19 pandemic, Federally Qualified Health Centers have played a key role in providing testing and care for those affected by the virus.

Their importance has not gone unnoticed. Congress provided $1.32 billion for coronavirus response under the CARES Act on top of the $100 million already appropriated under the Coronavirus Preparedness and Response Supplemental Appropriations Act. The funding helps centers with the detection, prevention, diagnosis, and treatment of COVID-19 and enabled health centers to maintain or increase their staffing levels, conduct training, purchase personal protective equipment, and administer millions of tests for both existing and new patients.

Addiction Treatment:

In recent times, federally qualified health centers have been on the front lines in combatting the nation’s opioid crisis. In 2019, health centers screened and identified approximately 1.4 million people for substance use disorder and ultimately provided medication-assisted treatment to more than 140,000 patients nationwide. This is an increase of 120% since 2017. In 2019, 93 percent of health centers provided mental health counseling and treatment and 70 percent of health centers provided substance use disorder services. A study published by the National Institute of Health examined real-world substance abuse treatment outcomes in patients within a federally qualified health center network. Study results found that medication-assisted treatment, specifically buprenorphine, had similar retention rates in an federally qualified health centers compared to other health care settings. As previously observed in other studies, opioid use decreased with improved retention (Haddad, Zelenev & Altice, 2013). While the study did emphasize the need for providing substance abuse counseling and screening and treating medical and psychiatric comorbidity, it shows how effective and important federally qualified health centers are in providing treatment care in underserved areas on the same scale as larger hospital networks in urban centers.

HIV Epidemic:

Federally qualified health centers are also an essential component in the ending the HIV Epidemic. These centers serve as a key point of entry for detection and diagnosis of people living with HIV. In 2019, health centers provided approximately 2.7 million HIV tests to more than 2.2 million patients and treated 1 in 5 patients diagnosed with HIV nationally. Many health centers provide HIV care services, including Pre-exposure Prophylaxis (PrEP). Health centers emphasize coordinated and comprehensive care and have the ability to manage patients with multiple health care needs. Integration of HIV testing, prevention, care, and treatment into primary care settings and providing essential enabling services such as outreach, patient education, case management, and care coordination, can increase access and improve health outcomes for patients living with HIV.

According to CDC estimates, more than 1.1 million people in the United States are living with HIV infection, and almost 1 in 7 are unaware of their infection. Many are members of vulnerable populations and underserved communities—the exact communities served by federally qualified health centers.

Summary:

Federally Qualified Health Centers are an integral part of the United States health care system. While they may not be immediately recognized by a majority of the American population, these centers are essential for millions of people. They care for the poor, elderly, or uninsured—ultimately helping to improve the overall health of the communities which rely on them.

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