We recommend $9 billion for Federally Qualified Health Centers (FQHCs), with 32% through annual appropriations and 68% through increased allocations for the Community Health Center Fund.
Federal FQHC funding should ensure a comprehensive medical home for all patients. Successful health care payment models average $25/patient/month to offer comprehensive, equitable primary care. This level of support can help to address the specific population health needs of each FQHC community. In addition, $9B ensures FQHCs can supplement public and private payer reimbursement, cover the costs of caring for the uninsured, offer competitive salaries to providers and support staff, and account for rising inflation.
$300/year x 30 million patients = $9B
Health centers’ ability to care for the increasing number of patients in need is dependent on the resilience of their physical facilities. Funds are necessary to restore and repair existing facilities, as well as offer expanded services and amenities that provide consistent patient safety and well-being. As with every dollar of FQHC funding, this investment is an opportunity for economic stimulus. Every dollar invested into capital improvement at a health center is also an investment in the local economies of rural and underserved communities.
$50/year x 30 million patients = $1.5B
Health centers are facing workforce shortages at crisis levels, which impact their ability to care for patients. We recommend investments to help retain current providers and support staff, fill current gaps, and build a more robust pathway. This includes $1B for National Health Service Corps, $100 million for Nurse Corps, $1B for Teaching Health Centers, and $400 million for health professional pathway programs such as the Health Careers Opportunity Program, Scholarships for Disadvantaged Students, and Area Health Education Centers.
$83/year x 30 million patients = $2.5B
We recommend $17 billion in annual funding for FQHCs, with 20% through annual appropriations and 80% through increased allocations for the Community Health Center Fund.
Federal FQHC funding is designed to ensure a comprehensive medical home for all patients. However, the cost of caring for patients, as well as the total number of patients, is expected to continue to increase dramatically in the coming years, to an estimated 40 million by 2030. With a 12.7% annual increase from the 2023 baseline ($9B) for a seven-year period, we can reach $17B in health center investments. This amount would account for the development and expansion of flexible alternative payment mechanisms, population health management costs specific to the communities FQHCs serve, as well as overall inflation. $17B would also allow FQHC spending per patient to average $425/year, which allows FQHCs to better address the comprehensive health care needs of each patient. In addition, to maintain stability, we recommend that health center funding is not subject to sequestration.
For health centers to continue to serve increasing numbers of patients at the highest level of quality care, they must be able to access capital to address their physical infrastructure needs. According to Capital Link, based on current and projected construction-related costs and capital investment trends, health centers will need to invest approximately $17.5 billion in property, plant, and equipment. We propose a down payment on this total, increasing annual funding by $571M every year from 2023 to 2030, ultimately reaching a sustained level of $5.5 billion. With this funding, Congress will enable health centers to work from a solid foundation, positioning these hyper-local healthcare hubs to sustainably provide comprehensive care to 40 million patients in underserved communities by the year 2030. From this investment, we recommend allocating funds sufficient to establish 200 new sites of care.
To continue to grow, innovate, and transform care, health centers must continually reinvest in staff development, retention, and recruitment. FQHCs and their patients rely on culturally and linguistically competent providers and support staff, and retention of such employees requires competitive salaries. Between FY 2023 and 2030, we recommend annual increases to reach a sustained annual investment of $6.5B in 2030, which would include:
Finally, we recommend that FQHC funding support the existing workforce to ensure salaries remain competitive and staff can flourish in a culture of continuous learning.
 This estimate is based on the fact that, at a current funding level of $125M/year, the THCGME program graduates an average of 286 residents annually, and we anticipate the program to increase approximately $339M every year for seven years to reach $2.5B in 2030.
As the COVID-19 pandemic proved, FQHCs are often the most important connective tissue in a community – whether they are connecting people to vital care, protecting them from disease, or addressing urgent social needs. Rather than recreating programs that exist outside these health care hubs, we recommend Congress reinvest in health centers’ ability to serve their communities and provide strong, sustainable health outcomes. Congress can do this by funding health center innovations; programs such as care transformation hubs, through which FQHCs set up closed-loop social needs referral networks, or emergency preparedness operations that support local health departments in disaster situations. Health centers are innovating each and every day to maximize their effectiveness and support to their patients and communities. This investment can harness these innovations for greatest impact and scalability across not just the health center network, but the health care system as a whole.