Community health centers: Promise and performance

This article provides a critical review of the literature on the quality and effectiveness of care provided by community health centers (CHCs) compared with other health care delivery models. Since the mid-1960s, CHCs have played a large role in providing comprehensive primary care to our nation's medically underserved. Recent changes in public policy and the health care marketplace have threatened the viability of the CHC delivery model. This review of structure, process, and outcome indicators suggests that CHCs have effectively reduced many barriers to access, promoted high-quality ambulatory care use among underserved populations, and reduced costly hospitalizations. While CHCs have been shown to save money for Medicaid, little research has-addressed the health-related outcomes of care. This article recommends specific areas of research essential to understanding the future performance of CHCs.