Impacts of the Affordable Care Act on community health centers characteristics of new patients and early changes in delivery of care

The aim of this study was to assess the impact of the Affordable Care Act (ACA) on community health centers (CHCs). Using electronic health records from the Community Health Applied Research Network, we assessed new patient characteristics, office visit volume, and payer distribution among CHC patients before and after ACA implementation, 2011-2014 (n = 442 455). New patients post-ACA were younger, more likely to be female and have chronic health conditions, and utilized more primary care (P < .05 for each). Post-ACA, clinics delivered 19% more office visits and more visits were reimbursed by Medicaid.

This work was supported by the Health Resources and Services Administration, contract no. HHSH250201400001C. The authors greatly appreciate the contributions of all CHARN nodes—Fenway Health, Alliance of Chicago, AAPCHO, and OCHIN, Inc; as well as their academic affiliates—University of Washington, University of California Los Angeles, Northwestern University, and Oregon Health & Science University; and their member CHCs—Chase Brexton Health Care, and Beaufort-Jasper-Hampton Comprehensive Health Services; Erie Family Health Center, Inc, Heartland Health Outreach, Howard Brown Health Center, Near North Community Health Center, North Community Health Center, and PCC Community Wellness; Asian Health Services, Charles B. Wang Community Health Center, Waianae Coast Comprehensive Health Center, and Waimanalo Health Center; Open Door Community Health Centers, Virginia Garcia Memorial Health Centers, Multnomah County Health Department, and OHSU Family Medicine at Richmond. The authors also appreciate the Data Coordinating Center at the Kaiser Center for Health Research; and in particular, the time and effort spent by analysts—Phil Crawford, MS, and Weiming Hu, MS.