Community Health Centers (CHC) are community-owned and operated public/private partnerships. By law, health centers service medically underserved areas – rural and urban communities with limited access to health care and a proven need and ability to impact poor health status. Community Health Centers provide services to those who other providers do not serve because of their high costs and complex health needs. The sites serve the working poor and uninsured as well as vulnerable and high-risk populations; such as pregnant women, migrant farm workers, the homeless, the disabled, the frail elderly and others.
CHCs are staffed by primary care physicians (pediatricians, general practitioners, family practitioners, obstetricians/ gynecologists, general internists), dentists, family nurse practitioners, and support staff. Some centers have dieticians and social workers or counselors who provide case-management, as well as psychologists, and other mental health and substance abuse providers.
Health centers provide high quality preventive and primary health care to patients regardless of their ability to pay. Approximately 1 in 14 people, and 1 in 10 children, in the U.S. relies on a CHC for medical care. Nearly 1,400 health centers operate 9,800 service delivery sites in every U.S. state, D.C., Puerto Rico, the Virgin Islands and the Pacific Basin; these health centers employ more than 170,000 staff who provides care for nearly 23 million patients. For millions of Americans, including some of the most vulnerable individuals and families, health centers are the essential medical home where they find services that promote health, diagnose and treat disease and disability and help them cope with environmental challenges that put them at risk. CHCs are clinically effective and they provide more than just treatment of sporadic disorders and acute illnesses. They are successful in the promotion of on-going care. CHCs give the medically underserved a “safe haven” whose presence maintains the holistic well-being of its patients.
Community Health Center services are not free. Those who can afford to pay are expected to do so. Medicaid, Medicare and private insurance are billed for those with coverage. Patients who are uninsured are charged by providing sliding fee discounts to ensure that income or lack of insurance coverage is not a barrier to care. Federal grants are used to subsidize the costs of caring for sliding fee patients.
How do CHCs Differ from Other Providers?
Few federal programs have made a significant contribution to low income families, as cost effectively and with such high quality, as Community Health Centers. There are many characteristics that distinguish health centers from most other health care providers. These include:
- Location in underserved neighborhoods
- Understanding and responding to their communities’ most urgent health care needs
- Caring for those whom other providers cannot or will not serve
- Commitment to offering case management ranging from medical and dental to counseling
- Availability of sliding fee scale, based on client’s ability to pay
- Major impact on the health of their communities in a highly cost effective manner
These characteristics make health centers extraordinarily effective providers for families and individuals otherwise isolated from medical care because of geographical, financial, or cultural barriers.
What are the Keys to Effectiveness?
Health center quality of care equals and often surpasses that provided by other primary care providers. Overall, health centers emphasize coordinated primary and preventive services or a “medical home” that promotes reductions in health disparities for low‐income individuals, racial and ethnic minorities, rural communities and other underserved populations. Two-thirds of health centers, including Mālama I Ke Ola Health Center, have been designated as patient centered medical home, which mean they emphasize care coordination and communication to improve quality, lower costs and enhance both the patient and provider experience.
CHCs provide real value-care that is effective in terms of impact, and efficient in terms of cost. CHCs demonstrate the cost of medical care while meeting the health needs of more Americans. They also exert an economic impact in the communities they serve. Health centers upgrade neighborhoods, return federal tax dollars to areas of need, employ community people, attract other businesses, and draw customers for these businesses. Their systems of care, cross coverage and backup, plus the opportunity to feel good about one’s work, make them attractive to providers. As they look to the future, CHCs bring a record of high quality and able performance in their part of the health care market.