Healthcare for rural Americans is often inaccessible, with patients facing unique obstacles that can impede the ability to seek or receive care. These disparities in healthcare are influenced by economic, social, and cultural factors, such as lack of education, transportation, and geographic isolation. Federally Qualified Health Centers (FQHCs) serve as a means of providing primary care to underserved rural communities.
According to Definitive Healthcare clinics data, there are more than 1,300 FQHCs in the U.S. In order to achieve FQHC status, facilities must abide by strict operating requirements, such as answering to a governing board that includes patients and offering care based on sliding-scale payments. These facilities can also be equipped to provide telehealth services if specialists or other clinicians are not available nearby.
Below, we've listed the top FQHC facilities with the greatest number of total visits.
Top 10 FQHCs by Total Visits
- Ventura County Health Care Agency (CA): 550,886
- Family Healthcare Network (CA): 472,555
- Borrego Community Health Foundation (CA): 446,778
- County of Santa Clara (CA): 424,079
- Hudson River Healthcare Inc (NJ): 359,717
- Family Health Centers of San Diego (CA): 352,680
- Yakima Valley Farm Workers Clinic (WA): 345,600
- Sea Mar Community Health Centers (WA): 317,619
- Clinicas Del Camino Real (CA): 314,681
- Community Health Center Incorporated (CT): 307,392
Fig 1 Data from Definitive Healthcare based on self-reported CMS Cost Report data through July 2018. Does not include FQHC look-alikes or service sites.
Half of the listed facilities are located in California, the state with the greatest number of active FQHCs. The state's peculiarly high volume of FQHCs is likely attributed to a large population and significant enrollment in Medi-Cal, the state version of Medicaid. According to Definitive Healthcare data, California reported nearly 180 active FQHCs as of July 2018. Texas and New York are the next two states with the most FQHCs, reporting 73 and 65 facilities respectively.
Health inequity is a continuing issue for rural Americans, largely due to accessibility and affordability. More than 50 percent of vehicular accident deaths occur in rural areas, and the risk of injury-related death is 22 percent higher than in urban areas. The increased mortality rate is likely due to the proximity of care centers and availability of clinicians. Rural communities report an average patient-to-primary care physician ratio of 39.8 physicians per 100,000 people, much lower then the 53.3 physicians per 100,000 people reported in urban areas. When medical issues arise in rural America, patients face longer travel times and greater financial costs due to differences in insurance coverage.
For more information on the top 25 FQHCs by total visits, download our Definitive List!