Strategy. Federally Qualified Health Centers (FQHCs)
Approach. Expand the number of FQHCs in the state to provide preventive care services to the underinsured
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Overview. Federally qualified health centers (FQHCs) are public and private non-profit healthcare organizations that receive federal funding under Section 330 of the Public Health Service Act. Governed by a community board, FQHCs deliver comprehensive care to uninsured, underinsured, and patients who may need additional support, regardless of ability to pay.
Evidence. Scientifically Rigorous Evidence.
Strategies with this rating are most likely to be effective...
Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.
Potential Data Sources. Data to support this strategy can be accessed through:
- FQHC-specific data and reports
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Community health needs assessment data
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Local health department data
Outcome Components.
This strategy has shown to have impact on the following outcomes
(Read more about these categories):
- Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
- Cost. This strategy helps to decrease the financial expenditure incurred by individuals, healthcare systems, and society in general for healthcare services.
- Health Care Access for All MCH Populations.
Detailed Outcomes.
For specific outcomes related to each study supporting this strategy,
access the peer-reviewed evidence
and read the Intervention Results for each study.
Intervention Type.
Direct Care (Read more about intervention types and levels as defined by the
Public Health Intervention Wheel).
Intervention Level.
Community-Focused
Examples from the Field.
Access descriptions of ESMs
that use this strategy or aligned components.
Sample ESMs.
Here are sample ESMs to use as models for your own measures using the RBA framework
(see The Role of Title V in Adapting Strategies).
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Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)
- Number of new FQHCs established or existing FQHCs expanded with support from Title V agencies to increase access to preventive care services. (Measures the growth and spread of the FQHC network)
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Number of preventive care services, including well-woman visits, cancer screenings, and immunizations, delivered by FQHCs to patients. (Measures the volume and scope of preventive care provided by FQHCs)
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Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)
- Percent of FQHCs that meet or exceed national benchmarks for patient access, quality of care, and preventive service delivery, as defined by the Health Resources and Services Administration (HRSA). (Measures the performance and effectiveness of FQHCs in providing high-quality care to the underinsured)
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Percent of FQHC staff, including primary care providers, nurses, and community health workers, who receive regular training on evidence-based preventive care guidelines. (Measures the workforce development efforts to ensure the delivery of appropriate preventive services)
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Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)
- Number of partnerships and collaborations established between FQHCs, Title V agencies, managed care organizations, and community-based organizations to leverage resources and expertise in expanding access to preventive care. (Measures the level of multi-sector collaboration and collective impact)
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Number of policy and promotion initiatives undertaken by FQHCs and Title V agencies to secure sustainable funding, reduce regulatory challenges, and promote the value and impact of FQHCs. (Measures the efforts to create an enabling environment for FQHC growth and sustainability)
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Number of children and adolescents who receive essential preventive services, such as developmental screenings, vision and hearing tests, and oral health assessments, through FQHCs. (Measures the role of FQHCs in promoting the long-term health and well-being of underinsured youth)
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Number of adults who benefit from early detection and intervention for chronic diseases and cancer through preventive screenings provided by FQHCs. (Measures the impact of FQHCs on secondary prevention and disease management)
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Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)
- Percent of FQHC governing boards that include representatives from the community and reflect the patient population served. (Measures the level of community engagement and accountability in FQHC decision-making)
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Percent of FQHC preventive care services that are tailored to address the unique social, economic, and environmental determinants of health faced by patients, such as transportation challenges, food insecurity, and unstable housing. (Measures the responsiveness and comprehensiveness of FQHC services in meeting the complex needs of the underinsured)
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Percent of patients who report reduced financial strain through receiving affordable preventive care services through FQHCs. (Measures the role of FQHCs in promoting financial protection and health security for the underinsured)
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Percent of overall healthcare spending in the state that is shifted from costly acute and specialty care to cost-effective preventive and primary care as a result of the expanded availability and utilization of FQHC services. (Measures the long-term system-wide impact and return on investment of FQHC expansion in improving population health and controlling healthcare costs)
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Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.
Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.
