social determinants of health

FQHCs are an essential component of the healthcare safety net in the U.S. They provide comprehensive primary care services to underserved and vulnerable populations. Ensuring that individuals and communities who might otherwise lack access to vital healthcare resources receive the medical attention and support they need. 

This article explores the impact of FQHCs to help you understand how they have changed the world for the better. 


What are FQHCs?      

FQHCs are health centers that provide comprehensive primary care services, including medical, dental, and behavioral health services, to all patients regardless of their ability to pay or health insurance status. They charge a sliding fee scale based on the patient’s income, family size, and other factors. This approach improves access to healthcare services for individuals and communities with limited access or resources. 

To receive an FQHC designation, health facilities must: 

  • Provide comprehensive primary care and advanced care plans for patients of all ages. 
  • Operate as a non-profit with a board of directors that includes patients. 
  • Offer a sliding scale fee based on the patient’s ability to pay. 
  • Serve a medically under-served area. 
  • Employ interdisciplinary teams and patient-centric approaches. 

The Health Resources & Services Administration (HRSA) Health Center Program funds FQHCs, as Section 330 of the Public Health Service (PHS) Act authorized. This funding allows them to offer high-quality healthcare services to low-income individuals and communities at affordable rates. 

The term “health center” also encompasses FQHC look-alikes. FQHC look-alikes are organizations that meet the criteria for FQHCs but don’t receive grant funding under section 330. They provide similar services to FQHCs and receive many of the same direct benefits that FQHCs receive, such as: 

  • 340B Drug Pricing Discounts for pharmaceutical products 
  • Access to onsite HHS out-stationed eligibility workers 
  • Access to the Vaccines for Children (VFC) program 
  • Access to National Health Service Corps placements to provide additional health care provider staff. 


The history of FQHCs 

In 1964, as part of President Lyndon B. Johnson’s “War on Poverty,” the Office of Economic Opportunity established Neighborhood Health Centers under the Economic Opportunity Act of 1964. Their legislative goals were to: 


  • Provide comprehensive, high-quality health services. 
  • Be accessible to low-income residents. 
  • Be responsive to patient needs. 
  • Offer employment, education, and social assistance. 

By 1965, there were only two Neighborhood Health Centers—one in Mound Bayou, Mississippi, and the other in Columbia Point, Boston. The numbers have steadily grown, evolving FQHCs into critical components of the U.S. healthcare system. 

By 1980, there were about 400 FQHCs, almost doubling by 2001, reaching 748. In 2023, there are over 1,400 official FQHCs and more than 100 FQHC look-alike organizations. Together, these health centers operate more than 15,000 service delivery sites. 

Apart from providing employment, education, and social assistance, the original legislative goals continue. They have expanded to include additional services like pharmaceutical, oral and mental health, and preventive care. 

Federally Qualified Health Centers


What makes FQHCs different from other entities? 

FQHCs go beyond simply providing healthcare services. They have several distinct features and offer unique services that make them essential components of the country’s healthcare safety net. Here are some things that make FQHCs different from other health centers. 

Sliding fee scale 

FQHCs use a sliding fee scale based on patients’ income and family size. This approach allows low-income individuals to access the healthcare they need. 

Comprehensive services 

FQHCs offer several primary care services within a single facility, including medical, dental, and behavioral health services. This approach allows patients to address multiple health needs in one location. 

Focus on underserved areas 

FQHCs are located in medically underserved areas, such as rural communities, inner cities, and regions with high poverty rates. These areas have limited access to healthcare services, and the populations face barriers to receiving essential medical care. FQHCs focus on meeting the medical needs of the populations of these areas, whether they can pay for them or not. 

Patient representation in governance 

FQHCs are managed by a board of directors that represents the area volunteers. They are required to have patient representation on their governing boards. At least 51% of the board of directors must use the services of the healthcare center. Including patients’ perspectives in decision-making ensures that the services of the health center align with the needs of the community it serves. 

Required enabling services 

FQHCs offer enabling services like outreach, transportation, translation, and education about services to individuals of all ages. These services address social determinants of health and remove barriers that could hinder patients from accessing care. 


The impact of FQHCs 

FQHCs have an extensive reach and profound impact on vulnerable and underserved populations. According to the HRSA Bureau of Primary Health Care, over 9.6 million rural residents, nearly 1.4 million homeless individuals, and 24.2 million uninsured, Medicaid, and Medicare patients were served by FQHCs in 2022 only. Additionally, 1 in 12 people in the U.S. rely on FQHCs for care. 

Without FQHCs, many of these individuals couldn’t access essential healthcare services. It could lead to delayed diagnoses, untreated chronic conditions, increased emergency room visits, and health disparities. 

According to a National Library of Medicine study, higher FQHC penetration was associated with reduced COVID-19 mortality rates across 4 major US cities. This highlights the importance of the high-quality health care that FQHCs deliver and their role in the lives of vulnerable individuals and communities. 

The number of people seeking their services has been steadily rising over the years due to the growing awareness about the availability of the services. The key impacts of FQHCs can be summarized as follows: 

  • FQHCs have dramatically improved healthcare access to individuals with limited or no access. 
  • The health centers reduce health disparities by providing quality care regardless of socioeconomic status. 
  • FQHCs emphasize preventive care and health education, leading to early detection of health issues and better management of chronic conditions. This approach reduces the burden on emergency services. 
  • The health centers prioritize patient involvement and patient-centered care, improving patient satisfaction. 
  • FQHCs positively influence public health behaviors and awareness by engaging in community health initiatives and education programs. 

Deliver value-based care with Clinify Health 

FQHCs play an integral role in providing care to underserved and vulnerable Americans. They serve all patients regardless of their insurance status or ability to pay, ensuring people with limited resources can access the necessary healthcare services. They have had a huge impact on healthcare for decades, which will likely keep increasing as more people become aware of FQHCs and their funding increases. 

If you would like to deliver value-based care to patients in underserved communities, Clinify Health can help you. Clinify Health is a digital healthcare organization that partners with healthcare providers to support value-based care delivery for underserved communities. You can learn more about Clinify Health features or contact us today to learn how the solutions can improve the economics and outcomes of healthcare while distributing higher quality care at a lower cost. 

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