title: An overview: health centers at the crossroads.
abstract: Health centers' flexibility in meeting changing political and economic demands throughout their history has allowed them to evolve and expand. In 1997, they served 8.3 million patients--40% uninsured and 35% Medicaid recipients. Thus far, most centers have been able to balance their mission of serving the underserved with economic survival. However, their future viability is threatened, by downward pressure on revenues, coinciding more frequently with growing numbers of uninsured patients. The centers' value as essential safety net providers, their adaptation to marketplace realities and their performance in terms of cost and quality outcomes appears to justify the increased subsidy that may be needed for continued operation.
authors.affiliation: Office of Population Affairs, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: B
authors.initials: B
authors.lastname: Lefkowitz
authors.forename: J
authors.initials: J
authors.lastname: Todd
mesh_terms: D003151:Community Health Centers / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D017048:Health Care Costs; D008329:Managed Care Programs / Q000706:statistics & numerical data; D008484:Medicaid; D008507:Medically Underserved Area; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D017146:Models, Organizational; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care; D014481:United States