Changes in Primary Care Access at Community Health Centers Between 2012/2013 and 2016


Objective: To compare access at community health centers (CHCs) vs private offices (non‐CHCs) under the Affordable Care Act.

Data Source: Ten state primary care audit conducted in 2012/2013 and 2016.

Study Design: CHCs and non‐CHCs were called. We calculated difference in differences comparing CHCs vs non‐CHCs by caller insurance type.

Principal Findings: In both rounds, Medicaid and uninsured callers had higher appointment rates at CHC than non‐CHCs. CHC appointment rates significantly increased between 2012/2013 and 2016 for both employer‐sponsored and Medicaid callers, with no significant wait time changes. Appointment rates increased (13.5% points, P < 0.001) and wait times decreased (−5.7 days, P = 0.017) at CHCs relative to non‐CHCs for employer‐sponsored insurance.

Conclusion: Appointment availability at CHCs improved after ACA implementation, without increased wait times.