Access Indicators: Safety Net ClinicsThe current supply of safety net clinics only meets 36% of the demand for health care by the working poor. There are nearly 1.5 million people in the nine-county region who are uninsured at any given time, and it is estimated that they need approximately 4.2 million visits. More below…
FQHCs have been a significant part of the national health care delivery system for almost 50 years, yet this region did not take advantage of this program until recently. Harris County organized its first FQHC in 1994, obtaining a second one only in 2004.
At the request of the Center for Houston’s Future, Dr. Charles Begley, of UT School of Public Health, and Dr. Jeanne Hanks, of St. Luke’s Episcopal Health Charities, conducted ground-breaking work to determine the gap between the supply and demand for primary care clinics among the working poor in the eight-county region. They projected the future gap between supply and demand following full implementation of the Affordable Care Act (ACA).
The study found that in 2012, there was enough capacity/supply to serve 36% of the primary care demand of the working poor through safety net clinics. However, as the ACA is fully implemented, demand will increase as more working poor gain access to insurance. If demand increases by 11%-14%, and there is no growth in clinic supply, the proportion of primary care met by safety net clinics will be reduced from 36% to 31%-33%. The study concluded that the remaining demand will have to be met by increased capacity among private practice, non-safety net providers — including hospital emergency rooms — or people will go without primary care (Begley et al., 2012).
The safety net capacity graph on this page shows that, with the exception of Chambers County, most counties in the region experience a supply gap for safety net providers of 60%-plus. This gap is expected to increase given two different ACA scenarios (Begley et al., 2012). Failure to meet the increased demand for primary care through expansion in safety net and private-practice primary care capacity is likely to further burden our already overtaxed emergency room facilities.