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VOLUME 49 | NUMBER 3 | JUNE 2014


Expanding Federal Funding to Community Health Centers Slows Decline in Access for Low-Income Adults

Keywords: Health centers;access to care; primary care; safety net.

Objective: To identify the impact of the Health Center Growth Initiative on access to care for low-income adults.

Data Sources: Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000–2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001–2008).

Study Design: We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage.

Data Collection: We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions.

Principal Findings: Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults.

Conclusions: Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period.

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