As funding shortfalls threaten hundreds of federally qualified health centers nationwide, hospitals are bracing for the familiar downstream effects: a spike in avoidable health crises, longer emergency response times and fuller emergency departments.
“When you close an FQHC … it’s a ripple effect through the entire emergency care chain all the way from dispatch to access to hospital beds,” Sheree Lowe, vice president of policy for the California Hospital Association, told Becker’s.
Nationwide, FQHCs offer crucial preventive care services — including primary care, behavioral health and dental care — for nearly 34 million low-income patients, according to an Oct. 3 report from KFF Health News. At least 1,500 centers are facing financial hardship as federal funding mechanisms, such as grants from the Community Health Center Fund, dry up and Medicaid cuts loom. The challenges mean some centers may need to reduce staff or services, while others have already closed in states like Virginia, according to the report.
The loss of preventive care services in a community can cause significant downstream ripple effects across the healthcare system, according to Ms. Lowe. She said service reductions could lead to greater strain on the state’s emergency departments, which have already seen a 25% increase in patients between 2020 and 2023.
“It just means there are going to be more health crises,” she said. “There are going to be more calls into the 911 system, more ambulances tied up with avoidable transport, and it’s going to result in longer emergency response times and overcrowded emergency departments.”
Ms. Lowe pointed to a 2019 study from the University of California San Francisco Fresno, which found that increasing the geographic density of FQHCs in California was associated with a 26% to 35% drop in ED use among uninsured patients between 2005 and 2013.
For hospitals and health systems, access is paramount amid these headwinds. Many organizations are ramping up community partnerships, opening urgent care clinics and expanding preventive services to keep patients out of the ED and connected to routine care. Some are also exploring virtual and community-based models — such as telehealth check-ins, paramedicine programs and mobile clinics — to fill care gaps left by FQHC closures.
But those efforts can only go so far without policy intervention, according to Ms. Lowe. She called for federal and state leaders to address systemic fragility through sustained, coordinated funding and stronger oversight mechanisms.
“Closures are going to destabilize an already fragile infrastructure,” she said. “We need the highest levels of government looking at the entire system.”
