COVID-19: Exploring the Repercussions on Federally Qualified Health Center Service Delivery and Quality.

The COVID-19 pandemic has brought about a precipitous transformation in health care delivery in the nation's safety-net, primary care system of federally qualified health centers (FQHCs). This study uses electronic health record data to quantify the extent of changes to visit volume in 36 FQHCs across 19 states as well as changes in quality metrics. We found a steep decline in in-person visits in March 2020 accompanied by a sharp increase in telehealth visits; however, combined volume remained 23% below pre-pandemic levels. The implications for public health are significant, as preventive and chronic care deferral could lead to exacerbations of health disparities. Our examination of the impact on quality measures suggests that gaps in care are already emerging. Services that cannot be readily performed virtually are most affected. As FQHC visit numbers recover, concerted efforts are needed to encourage access and re-engage at-risk groups that fell out of care.

Addressing the Health Needs of the Uninsured: One Community's Solution.

INTRODUCTION: Providing high-quality health care to poor and uninsured individuals has been a challenge to the US health care system for decades. Often, patients do not seek care until they are in a crisis, or they seek care at a health care system while not addressing their primary care needs. OBJECTIVE: To report on a community that has sought to change this dynamic with the development of an all-volunteer practitioner-run clinic model. METHODS: Perspective on a successful volunteer-run safety-net clinic. RESULTS: Volunteers in Medicine on Hilton Head Island, SC, provides free health care, with more than 28,000 eligible patient visits annually, for the underserved population. This clinic is self-funded through donations and charity events and accepts no federal money. The patients are not asked to pay a fee for service. Most medical specialties are represented at the clinic, and many partnerships are in place for referrals for more advanced procedures such as surgery. All health care clinicians are volunteers, including physicians, nurses, dentists, and mental health professionals. DISCUSSION: The quality of care meets or exceeds national recommendations on many measurements, including mammography and Papanicolaou test screening rates. CONCLUSION: Safety-net clinics such as Volunteers in Medicine are a needed and viable option to the provision of health care to the vulnerable, often unseen members of society.

Access to and Disparities in Care among Migrant and Seasonal Farm Workers (MSFWs) at U.S. Health Centers.

OBJECTIVES: This study describes the characteristics of migrant and seasonal farm workers (MSFWs) served by federally-funded health centers and examines disparities in access to primary and preventive care between migrant health center (MHC) and community health center (CHC) program patients. METHODS: Cross-sectional analysis of the 2009 Health Center Patient Survey which has 2212 and 831 patients from CHC and MHC program patients, respectively. RESULTS: Our study showed that the MHC program provided comparable health care access and quality for MSFWs relative to CHC patients. However, there were challenges with access to primary care, such as getting timely medical and dental care and prescription medicine. DISCUSSION: These results affirmed the role of health centers in providing high-quality primary care and reducing disparities. However, continual efforts are needed to enhance access to and quality of care for MSFWs.