The History & Importance of America’s Health Centers

Key Topics:

What is a Health Center?

According to the Health Center Advocacy Network, "Health centers provide access to basic health care services in the communities that need them most. Their doors are open to everyone – families and children, farmworkers and the homeless, and those who are uninsured, on Medicaid recipients, or have private insurance."

Crescent Community Health Centers elaborate by saying there are over 1,400 community-governed, not-for-profit locations in the U.S. aimed at improving the health and well-being of the areas they serve. These centers are in what is classified as "Medically Underserved Areas," or areas that would typically lack access to medical providers.

According to the Health Resources and Services Administration (HRSA):

Medically Underserved Areas/Populations are areas or populations designated by HRSA as having too few primary care providers, high infant mortality, high poverty or a high elderly population. Health Professional Shortage Areas (HPSAs) are designated by HRSA as having shortages of primary medical care, dental or mental health providers and may be geographic (a county or service area), population (e.g. low income or Medicaid eligible) or facilities (e.g. federally qualified health center or other state or federal prisons).

Across America, communities health centers have a significant role in ensuring basic health for low and uninsured populations and the poor. A further category is the nonprofit and medical provider organizations that are operated by federal guidelines. They also have federal grants in order to maintain health coverage.

These Community Health Centers (CHCs) are also referred to as Community/Migrant Health Centers (C/MHCs), Federally Qualified Health Centers (FQHCs), and 330 Funded Clinics (Definitive Healthcare, n.d.).

Federally Qualified Health Centers (FQHCs) receive funds from the HRSA Health Center Program to provide primary care services to these underserved areas. According to HRSA, FQHCs "must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients. "Many Health Centers also accept commercial insurance offered by employers.

Types of Federally Qualified Health Centers

Definitive Healthcare notes the following four types of Federally Qualified Health Centers (FQHCs), which allow location growth from over 1,400 health centers to nearly 18,000 sites nationwide:

  1. Federally Qualified Health Center - An FQHC is an administrative parent that receives a Section 330 grant. Upon receiving the grant, they receive the FQHC designation.
  2. Federally Qualified Health Center Look-Alike - An FQHC Look-Alike serves the same administrative purposes as an FQHC. However, it did not receive a Section 330 grant.
  3. Federally Qualified Health Center Service Site - An FQHC Service Site is a location providing services for a qualified FQHC. All FQHC Service Sites have an FQHC parent.
  4. Federally Qualified Health Center Look-Alike Service Site - An FQHC Look-Alike Service Site can operate under an FQHC or an FQHC Look-Alike. A service site may be classified as a Look-Alike for two reasons. (1) They were added after the grant funding for the current year was issued and are not included in that grant. Or (2) the administrative parent did not receive Section 330 funding and was designated an FQHC Look-Alike.

2022 Data shows that Service Cites have the most locations at 15,838, representing 89% of the total 17,890 locations in the U.S. (How Many Federally Qualified Health Centers Are There?, n.d.).

History of Health Centers

Health Centers were created in the 1960s as part of President Lyndon B. Johnson's "War on Poverty" (National Association of Community Health Centers, 2020).

"The Comprehensive Health Planning Act, passed in 1967, established a nationwide system of health planning agencies and allowed development of community health centers across the country" (Institute of Medicine, 1988).

According to the New England Journal of Medicine, "The law sets forth as a national goal, 'the highest level of health attainable for every person'".

Their mission was clear and one that still endures today (National Association of Community Health Centers, 2015):

To provide healthcare to underserved communities where there are few or no options for care.

Through bi-partisan support, the footprint and offerings of Community Health Centers have continued to spread (National Association of Community Health Centers, 2015):

In 1975, ten years after its inception, the Health Center Program was authorized for the first time in federal law and placed under what later became the Department of Health and Human Services. By that year, there were more than 100 Health Centers serving 2 million patients.

For over 50 years, our community health centers have been serving communities to ensure everyone has access to the healthcare they deserve (National Association of Community Health Centers, 2015).

Timeline of Community Health CentersTimeline of Community Health Centers (Image Credit: National Association of Community Health Centers, 2015a)

Health Centers Today

While the above chart ended in 1992, the bipartisan support for community health centers has continued. In 2001, the Health Center Growth Initiative was launched to increase access to primary health care services. The expansion increased the number of patients treated by 60% (16.25 million total) (Office of the Press Secretary, 2007).

The Affordable Care Act (ACA) further enabled patient growth at community health centers – growing to 28.4 million patients by 2018 (Gibson et al., 2020).

This growth allows health centers to now provide services to over 29 million people annually. That means 1 in every 11 people receive healthcare services at a community health center (National Association of Community Health Centers, 2020).
According to Health Center Advocacy Network, health centers save the healthcare industry more than $24 billion annually in reduced costs including emergency, hospital, and specialty care costs. Health centers saves $1,263 or 24% per patient per year (National Association of Community Health Centers, 2020).

Importance of National Health Centers

Sustainability is broken down into three pillars:

Did we mention that all health centers are required to engage in quality improvement (QI) and quality assurance activities? (National Association of Community Health Centers, 2015b). So, not only do these cost-effective health centers save the health care system nearly $24 billion annually, but they also perform well on 94% of quality measures (Health Center Advocacy Network, 2022).

Furthermore, KFF highlights, health centers are essential to communities of color and help narrow racial and ethnic disparities. They state that health center patients are more racially and ethnically diverse than the low-income population overall as patients tend to be:

  • Hispanic
  • African American
  • Or a member of another racial or ethnic minority group

They highlight how patients are less likely to be White than the general low-income population (38% of health center patients vs. 47% of low-income population.)

National Health Center Week

For all these reasons and more, we celebrate our health centers. National Health Center Week is an annual celebration each year from August 7 – 13. The celebration has been occurring for over 30 years and was created by the National Association of Community Health Centers (NACHC), who recognized the benefits of joining together to celebrate and showcase the programs provided.

NACHC outlines the goals of National Health Center Week as:

  1. Celebrate Community Health Centers
  2. Increase Awareness & Community Buy-in
  3. Advocate for Community Health Center Funding & Policies

Each year they select a new theme to raise awareness about the mission and accomplishments of America's health centers. This year's theme: Community Health Centers: The Chemistry for Strong Communities

Each day is dedicated with a specific focus to highlight the unique features and services provided by health centers:

  • August 7 — Public Health in Housing
  • August 8 — Healthcare for the Homeless
  • August 9 — Agricultural Worker Health
  • August 10 — Patient Appreciation
  • August 11 — Stakeholder Appreciation
  • August 12 — Health Center Staff Appreciation
  • August 13 — Children's Health

Public Health in Housing, Healthcare for the Homeless, and Agricultural Worker Health

Health centers serve greater portions of special populations like those who work in agriculture (4% health center population vs. 0.9% U.S. population), experience homelessness (5% vs 2%), or are residents of public housing 16% vs 0.6%).


Graph showing that Health Centers serve greater portions of special populations as compared to U.S. population.


Patient Appreciation

Legally, the volunteer board members at a Community Health Center must be comprised of at least 51% of volunteers from their community who consume the CHCs services (Kodiak Community Health Center, n.d.). This day celebrates the patient and community board members who ensure the voice and needs of the community is being heard.


Stakeholder Appreciation

Earlier, we noted how important bipartisan support has been to the growth of health centers. On this day, you're encouraged to engage with your legislators to thank them for the bipartisan support that has empowered the growth of health centers throughout the years (National Association of Community Health Centers, 2020).


Health Center Staff Appreciation

Our community health centers would not be possible without the love and support provided by passionate and dedicated healthcare workers and staff. This video highlights their impact on the lives of so many in their communities.


Children's Health

Community Health Centers serve as the primary care provider to more than eight million children annually, serving one in nine children.16 They've partnered with Sesame Street in Communities to provide free resources to healthcare providers and parents/caregivers. View all here.

Future of Health Centers

Health centers have continued to provide premium primary care at a discounted or no-cost rate ensuring all have access to the healthcare services they need. In addition, these centers have been key in supporting public health priorities and responding to crises like the COVID-19 pandemic.

Today's health centers need your help to continue their mission. Like other healthcare facilities facing labor shortages, community health centers are no different:

"As of 2013, 62 million people experience inadequate or no access to primary care because of shortages of physicians in their communities" (National Association of Community Health Centers, 2014).

Last year, 97% of health centers had capital planned projects which would allow them to serve 38.5 million patients, up from the current 29 million. Almost half are unsure of how they will obtain funding (National Association of Community Health Centers, 2020).

Federal and state support, along with adequate third-party reimbursement, are critically important to keep pace with escalating health care needs and rising costs among populations served by health centers (National Association of Community Health Centers, 2020).

You can show your support by joining the Health Center Advocacy Network here: http://www.hcadvocacy.org/join/

If you're a community health center interested in working with ActivePure, contact us. We value our community health centers and would love to learn more about ways to help you provide the safest environment of care for your patients across the U.S.

Check out our work with Alabama Primary Health Care Association Conference:



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Definitive Healthcare. (n.d.). How many Federally Qualified Health Centers are there? Retrieved July 26, 2022, from https://www.definitivehc.com/blog/how-many-fqhcs-are-there

Gibson, G., Rosenbaum, S., Sharac, J., Shin, P., Velasquez, M., & Community Health Foundation, R. C. H. N. (2020, March). Community Health Centers Ten Years After the Affordable Care Act: A Decade of Progress and the Challenges Ahead (Policy Issue Brief #61). Milken Institute School of Public Health. https://www.rchnfoundation.org/wp-content/uploads/2020/03/FINAL-GG-IB-61-ACA-CHC-3.4.20.pdf

Health Center Advocacy Network. (2022, May 11). Become an Advocate. Retrieved July 26, 2022, from http://www.hcadvocacy.org/join/

How many Federally Qualified Health Centers are there? (n.d.). Definitive Healthcare. Retrieved July 26, 2022, from https://www.definitivehc.com/blog/how-many-fqhcs-are-there

Institute of Medicine. (1988). The Future of Public Health (1st ed.) [E-book]. National Academies Press. Retrieved July 26, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK218224/

Kodiak Community Health Center. (n.d.). What is a Community Health Center? Retrieved July 26, 2022, from https://www.kodiakchc.org/about/what-is-a-community-health-center/

National Association of Community Health Centers. (2014, March). The Medically Disenfranchised and the Shortage of Primary Care: The Role of Health Centers in Improving Access to Care. https://www.nachc.org/wp-content/uploads/2019/05/FINAL-2-pager-Medically-Disenfranchised-Fact-Sheet-March-2014.pdf

National Association of Community Health Centers. (2015a, March). Community Health Centers Past, Present, and Future: Building 50 Years of Success [Slides]. https://www.rchnfoundation.org/wp-content/uploads/2015/07/NACHC-50.pdf

National Association of Community Health Centers. (2015b, June). MODULE 2: HEALTH CENTER RESEARCH EXPERIENCE AND NEEDS.

National Association of Community Health Centers. (2020, January). Community Health Center Chartbook [Slides]. https://www.nachc.org/research-and-data/research-fact-sheets-and-infographics/chartbook-2020-final/. https://www.nachc.org

National Association of Community Health Center. (n.d.). Thursday, 8/11 – Stakeholder Appreciation Day. https://healthcenterweek.org/. Retrieved July 26, 2022, from https://healthcenterweek.org/legislative-appreciation-day/

Office of the Press Secretary. (2007, December 5). Fact Sheet: Meeting the Health Care Needs of Uninsured and Underserved Americans. The White House. Retrieved July 26, 2022, from https://georgewbush-whitehouse.archives.gov/news/releases/2007/12/20071205-2.html

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