A person’s ability to access health care often involves complex factors, extending beyond insurance or income status. Limited-English speakers, for example, may be uncomfortable and have difficulty communicating with clinical staff who speak only English. Many individuals lack transportation to an out-of-neighborhood health care provider. An individual may not have the necessary knowledge or skills to manage complex, multi-stage treatments. Supporting services—often referred to as enabling services—offered by health centers may help reduce these obstacles to health care and often attract patients. These services can include translation services, benefit or eligibility counseling, health education and transportation. Health centers provided 6.3 million visits related to enabling services in 2017, a 27% increase from 2010. Health centers fund these services from a variety of sources. Some states, for example, cover enabling services through Medicaid reimbursements. Other services are paid for through federal grants.
According to the Health Resources and Services Administration, since the beginning of 2009, health centers have increased the total number of patients served on annual basis by 3.1 million people and added more than 25,300 new full-time positions. In addition, a substantial number of individuals gained access to insurance coverage as a result of the ACA. In anticipation of this increased patient load, the ACA established the Community Health Center Fund, which provided $11 billion over a five-year period for the operation, expansion and construction of health centers throughout the nation. Despite increases in patient load, the capacity of health centers to serve patients has increased since the ACA and fewer health center patients reported facing barriers to care in 2014 compared to 2009.
Studies suggest health centers simultaneously provide clients with cost-effective services and generate economic activity in their communities. Health centers created more than $54.6 billion in total economic activity and supported more than 400,000 jobs in 2017.
Health centers provide preventive care such as immunizations, mammograms, prenatal care, and screening for prostate and other cancers. These preventive services are considered cost-effective because they are inexpensive to administer and help prevent problems or detect them early. Health centers also may avoid or reduce patients’ use of expensive emergency medical services. Research shows uninsured people who live in communities where there is a health center are less likely to visit an emergency room.
Health Centers and Telehealth
Telehealth—a tool that uses technology to provide health care and other health services remotely—is seen by many as one way to improve access to care. Telehealth can leverage the existing health care workforce by expanding the reach of providers and making services more convenient. Health centers are similarly looking to telehealth to help solve workforce shortages, overcome geographic barriers and offer access to specialty care. As of 2017, 600 of the 1,373 health center organizations provided services using telehealth technology in the following ways:
- 315 provided mental health services.
- 125 provided primary care services.
- 164 provided specialty care services.
- 147 managed patients with chronic conditions.
- 37 provided oral health services.
- 140 used telehealth technology for reasons not listed.