Health centers begin to see an increase in financial resources particularly for their COVID-19 response

 During 2020 and 2021, community health centers received several rounds of supplemental funding in order to address COVID-19 specific needs. Total health center revenue increased from $31.4 billion in 2019 to $34.5 billion in 2020. While the share of total revenue by source remained stable for most categories from 2019 to 2020 (Figure 10), the share of total revenue from Medicaid fell from 43 percent to 40 percent. This decrease is attributable to federal grants accounting for larger shares of total revenue in 2020, as Medicaid revenue remained stable at $13.6 billion in both years. Section 330 health center grant funding increased from $5 billion in 2019 to $6.1 billion in 2020, including $4.8 billion in regular grants and $1.3 billion in COVID-19 supplemental funding (under the Coronavirus Aid, Relief, and Economic Security Act). Accordingly, 330 grants increased from 16 percent of total revenue in 2019 to 18 percent in 2020. Other federal grants grew from two percent of total revenue in 2019 to four percent in 2020, the result in part of approximately $838 million from the Provider Relief Fund, which accounted for more than half (59 percent) of other federal grants in 2020. Health centers also received just under $50 million from COVID-19 Uninsured Programs in 2020, reported in other public insurance revenue.

Figure 10

2019

2020

Similar to the national picture, health centers in both Medicaid expansion and non-expansion states experienced declines in the share of revenue from Medicaid (Figure 11), although at the starting point in 2019, the share of Medicaid for non-expansion state health centers (28 percent) was much lower than for health centers in Medicaid expansion states (48 percent). Similarly in line with national changes, the share of total revenue from federal BPHC grants and from other federal grants increased from 2019 to 2020 for both groups. The infusion of new federal funds was likely critical to offsetting increased costs (total costs increased from $31.8 billion in 2019 to $33.8 billion in 2020)[24] and maintaining staffing.

Figure 11

Non-Expansion States 2019

Non-Expansion States 2020

Medicaid Expansion States 2019

Medicaid Expansion States 2020