![]() ![]() In this paper we seek to assess how the post-ACA expansion of FQHC sites expanded geographic access to care and for which populations using data on the locations of FQHC patients.Įxpansion of FQHC sites to underserved areas could help reduce geographic health disparities. #Medically underserved areas by zip code how to#Despite the new funding and growth in sites and patients, there remains no standard by which to assess this growth – in part because of uncertainty on how to best define the area served by an FQHC. During the initial CHCF authorization period from 2010 to 2015, the number of Grantees grew from 1,124 to 1,375, the number of FQHC delivery sites increased from 6,949 to 9,754, and the total number of patients served grew 25%, from 19.5 million to 24.3 million. FQHC delivery sites are owned by FQHC Grantee organizations (Grantees), which may operate multiple FQHC sites. The creation of the CHCF, along with the ACA’s Medicaid expansion, led to a dramatic increase in both the funding and growth of FQHCs. The Affordable Care Act established the Community Health Center Fund (CHCF) to support the expansion of FQHCs between 2011–2015, allocating $11 billion over five years. Rural areas were less likely to gain access to FQHCs, underscoring the persistent challenges of providing care in these areas.įederally Qualified Health Centers (FQHCs) are a critical component of the US primary care safety net. Post-ACA funding, the FQHC program expanded access into areas that were more likely to have higher rates of poverty and uninsurance, which could help address disparities in access to care. Measures of actual patient use provide a promising method of assessing FQHC service areas and access. MUA/Ps that gained FQHC access 2011–2015 included more poor, uninsured, publicly insured, and foreign-born residents than underserved areas that did not gain access, but were less likely to be rural ( p < .05). 49% and 71%) and ZIP codes with greater use of FQHCs among low-income residents (29% vs. Primary Care Service Areas or counties included a higher percentage of each FQHC’s patients (86% vs. ![]() ResultsįQHC service areas based on UDS data vs. MUA/P ZIP codes that did not gain access to FQHCs between 2011–15. We then compared the characteristics of ZIP codes included in Medically Underserved Areas/Populations (MUA/Ps) that gained access vs. #Medically underserved areas by zip code code#We defined FQHC service areas using total patient counts by ZIP code from the Uniform Data System (UDS) and compared this approach with existing methods. We defined FQHC service areas based on patient use and examined the characteristics of areas that gained FQHC access post-ACA. The Affordable Care Act (ACA) increased funding for Federally Qualified Health Centers (FQHCs). ![]()
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