Community Health Centers Continue to Show Major Growth

Health center patients, by insurance coverage type, 2000-2017

The numbers of patients served by the nation’s community health centers continues to increase significantly, according to a new study issued by the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health. The study documents the expanded array of services that community health centers across the country are now offering.

The study, released as part of the Collaborative’s signature policy brief series with the RCHN Community Health Foundation, examines health centers’ continued growth during 2017.  That year, health centers served nearly 28 million patients. The report is based on newly released data from the U.S. Department of Health and Human Services Uniform Data System, an ongoing annual reporting system offering in-depth information about community health centers.  

The report documents that between 2016 and 2017, the number of patients served grew by five percent. Between 2000 and 2017, the number of patients served nearly tripled and the numbers of Medicaid and privately insured patients increased by 78 percent and 77 percent, respectively.  Health centers serve one in every five uninsured people and, while the proportion of uninsured patients has steadily declined as a result of the Affordable Care Act, health centers continue to treat large numbers of patients without health insurance – 6.2 million in 2017.

The 2017 analysis includes an examination of the role played by health centers in caring for the elderly. Between 2010 and 2017, the number of elderly adults served grew by 77 percent, outpacing overall patient growth (40 percent) during the same time period. Correspondingly, the number of Medicare beneficiaries grew by 75 percent over that period.

While most patients use health centers for medical care, dental care accounted for one in seven visits during 2017.  Mental health also has emerged as a crucial health center service.  In 2017, more than 80 percent of health centers furnished dental care and nearly 90 percent provided mental health care. As the percentage of community health centers offering substance use disorder services has increased – from 20 percent of all health centers in 2010 to 35 percent in 2017 – medication assisted treatment has emerged as an increasingly common service. In 2017, health centers reported providing medication-assisted treatment to nearly 65,000 patients with opioid use disorder.

The ACA adult Medicaid expansion continues to be associated with far more robust growth. Health centers in expansion states have exhibited greater patient growth from 2010 to 2017 (43 percent) compared to health centers in non-expansion states (33 percent). Health centers in non-expansion states remain more reliant on grant funding. However, in both expansion and non-expansion states, grants continue to offer crucial support for costs associated with uninsured patients, clinical care for which no insurance coverage is provided, and the cost of enabling services that help patients get the care they need.   

“Community health centers have emerged as an indispensable part of the health care system, providing ongoing, high-value care to many of the nation’s most vulnerable people. The studies show that both a strengthened grant program and insurance expansion are essential to maintain growth in capacity and services,” said Feygele Jacobs, DrPH, President and CEO of the RCHN Community Health Foundation, whose ongoing gift supports the Geiger Gibson Program.  

Community Health Centers Continued to Expand Patient and Service Capacity in 2017 was written by Jessica Sharac, Peter Shin, Rachel Gunsalus and Sara Rosenbaum of the Milken Institute School of Public Health’s Department of Health Policy and Management.