A Foundation of Care

Community health centers play an important role in addressing the nation’s primary care gap.
By Jenna Hughes

September 2023- The Journal of Healthcare Contracting

Americans nationwide have experienced increased difficulty accessing affordable primary healthcare. Over 100 million Americans face barriers to accessing primary care, according to the National Association of Community Health Centers (NACHC). The gap in access to primary healthcare results in serious public health threats, “leaving nearly one-third of the population vulnerable to preventable chronic diseases and emerging threats like COVID-19 and influenza,” according to the NACHC.

Primary care providers diagnose and treat infectious diseases in vulnerable populations, and the need for their services has been intensified by the COVID-19 pandemic. Primary healthcare providers are often the first line of healthcare defense, providing patients with vaccinations, treatments, and health education. According to NACHC and the National Academy of Sciences, Engineering, and Medicine, “primary care is the only healthcare component where an increased supply is associated with better population health and more equitable outcomes.” Primary healthcare is integral to national public health and in preventing disease transmission. The NACHC advocates for primary healthcare services to be a nationally recognized health priority.

“The primary care gap is deepening in underserved communities across our nation due to a number of trending factors including rural hospital closures, a shortage of workforce that was exacerbated by COVID, increased medical specialization and an uneven distribution of providers across the U.S.,” said Amy Simmons Farber, AVP, Media Relations for NACHC.

A patient’s ability to access primary healthcare has seen these challenges along with a doubling of patient volume since 2014. Access to primary care services is an essential healthcare need, especially in underserved communities.

“The COVID-19 pandemic has shown us how a strong primary care foundation is essential to good public health and health equity. When one person goes without access to affordable preventive healthcare, we all feel the impact in some measure, whether it is higher healthcare costs or a crowded ER waiting room because there are patients who have no other place to go for a flu shot or diabetes treatment,” said Farber.

Community health centers and the primary care crisis

Community health centers are federally funded clinics that provide affordable healthcare to underserved communities. Health centers reduce barriers such as cost, lack of insurance, distance, and language for patients who would otherwise be unlikely or unable to access healthcare.

The National Association of Community Health Centers (NACHC) is an advocacy organization founded to promote patient-centered and accessible healthcare. The organization promotes healthcare that is culturally and linguistically competent and community directed to ensure more Americans have access to needed healthcare services. Health centers provide patients with primary medical care, dental, behavioral health, pharmacy access, and preventative services. “Primary care providers can treat the common cold, ensure healthy childhood development, prevent future illness, manage chronic conditions, and connect patients to specialty services. Having a usual source of primary care is associated with decreased emergency department use and lower health care costs throughout the lifetime,” according to Farber.

Medically disenfranchised individuals are often unable to access primary care due to cost barriers. According to the NACHC, over 90% of all health center patients are low-income, and 67% have an income below the federal poverty level. Low-income patients are vulnerable to chronic diseases that go undiagnosed and are therefore at a higher risk of spreading infectious diseases to others. To close the primary healthcare gap, social drivers that cause poor health such as diet, nutrition, mental illness, and homelessness must also be addressed.

“Health centers create jobs, generate economic impact, and bring positive health outcomes in the most challenged populations. Health centers’ formula for success is not just to prevent illness, but to reach beyond the conventional exam room to address the environmental factors or social drivers that make people sick,” according to Farber.

NACHC’s impact

Community health centers are the largest primary care network in the country, NACHC states, providing services to millions of Americans who would otherwise forgo healthcare. According to the NACHC, health center patients who used enabling services had 1.9 more health center visits in the past year, and a 12 percentage-point higher likelihood of getting a routine checkup. Health center networks increase access to primary healthcare, reduce health disparities, lower patient costs, and improve community health. 

“Health centers play a vital role in closing primary care gaps in underserved communities. The NACHC primary care study found that without health centers, 15 million more patients would be at risk of not having a usual source of primary care. Health centers provide essential services to these patients who otherwise might not have access to preventive care or treatment for basic health needs,” according to Farber.

Future of health centers

Many Americans rely on community health centers for their medical care. As challenges to healthcare access continue nationwide, the NACHC has sought to improve health center networks through strategic investments and national advocacy. The NACHC has been involved in initiatives that help fund education programs, scholarships, and loan repayment programs that encourage practitioners to work in primary care. Initiatives also include advocacy for increased funding of health centers and expanding provider networks to meet demand. Through national advocacy, the NACHC garners financial resources to support health centers with the net increase of medically disenfranchised patients.

“NACHC is very focused on ensuring that health centers can continue to expand their reach with targeted federal investment in the growth of the program as well as sustainable funding to train, recruit and retain the primary care workforce through important programs like the National Health Service Corps and Teaching Health Centers.”

Programs such as the National Health Service Corps and Teaching Health Centers support primary medical, dental, and behavioral healthcare providers. The National Health Service Corps assists students through scholarships and loan repayment programs. The Teaching Health Centers ensure low-income communities have access to primary healthcare. NACHC’s involvement in these programs increases a patient’s current and future ability to access quality healthcare by addressing primary care provider shortages.

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