Community Health Centers in a Changing U.S. Health Care System

For more than 30 years, community health centers (CHCs) have played a crucial role in serving some of the nation's most vulnerable populations. Driven by a mission to serve all, regardless of ability to pay, CHCs deliver services to poor and medically underserved patients through a network that includes migrant health centers, homeless health centers, and other community-based centers. Today, CHCs face an array of problems that threaten their ability to provide accessible, high-quality care to their patients. Like other safety net providers, CHCs have been affected by the growth of managed care, the expansion of the for-profit health care sector, and other profound changes in the nation's health care system. At the same time, longstanding problems such as lack of health insurance and high rates of preventable mortality and morbidity among minority and disadvantaged populations remain to be solved. The following analysis describes the importance of CHCs as a source of care for low-income and uninsured populations, discusses the impact of market changes on safety net providers,