Opportunities and Challenges for the Federally Qualified Health Center Program: A Critical Review

Federally Qualified Health Centers (FQHCs) were founded to improve access to primary health care for medically underserved areas and populations. Since their inception in the 1960s, FQHCs have grown to provide comprehensive primary care services to more than 31 million patients in 2023. In this review, we provide an overview of the role and growth of the FQHC program, summarize the existing evidence on its association with key outcomes, and discuss opportunities and challenges for the FQHC model. Evidence finds that FQHCs have played a crucial role in expanding access to primary care for low-income populations and that quality of care delivered in FQHCs often compares similarly or favorably to that of other settings. The ability to sustain and expand FQHCs' role is contingent, however, on stabilizing revenue streams and financing, developing comprehensive models of safety-net health care that include linkages with specialists, and implementing policies to support workforce recruitment and retention.