Health reform's impact on federally qualified community health centers: the unintended consequence of increased Medicaid enrollment on the primary care medical home

Health Care Manag (Frederick). 2013 Apr-Jun;32(2):99-106. doi: 10.1097/HCM.0b013e31828ef5d5.


The impact of recently passed health reform legislation may cause substantial changes in community health center (CHC) operations. The new legislation provides federal funding for center expansion, increased Medicaid enrollment, enhanced Medicare payments, training to increase primary care providers, and incentives to develop CHCs as accountable care organizations. Health reform could place CHCs in a vulnerable financial situation. Newly insured patients may seek care at private providers, whereas CHCs are left caring only for the uninsured. Thus, CHCs are unable to benefit from enhanced insurance payments needed to offset care given to the uninsured. Conversely, if CHCs participate in developing comprehensive care networks for low-income populations by strengthening referral networks, developing primary medical care homes and accountable care organizations, and investing in infrastructure, then health center medical care will be a desired option for the newly insured, and a robust safety-net system may result.

MeSH terms

  • Community Health Centers / economics
  • Community Health Centers / legislation & jurisprudence
  • Community Health Centers / organization & administration*
  • Cooperative Behavior
  • Delivery of Health Care / organization & administration
  • Health Care Reform* / legislation & jurisprudence
  • Health Care Reform* / organization & administration
  • Humans
  • Medicaid / statistics & numerical data*
  • Medically Uninsured
  • Patient Protection and Affordable Care Act / organization & administration
  • Patient-Centered Care / economics
  • Patient-Centered Care / organization & administration*
  • Poverty
  • United States