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George Washington University, School of Public Health and Health Services, Department of Health Policy


Geiger Gibson/RCHN Community Health Foundation Research Collaborative Policy Research Brief No. 10


Underserved Populations; Community Health Centers; Health Reform


This brief examines the factors underlying medical underservice. It finds that the number of Americans living in communities at risk for medical underservice is more than double the number of persons who are uninsured. The report notes that even with health insurance reform, these communities and providers that serve them will continue to be affected by elevated numbers of low income uninsured persons, as well as persons who may be seriously under-insured because of poorer health status and lower family income.

Describing health insurance expansion as the single most important strategy to alleviate medical underservice, the Brief also identifies a series of safeguards and investments essential to long term quality and efficiency improvements in underserved communities, which disproportionately bear the burden of infant mortality, as well as chronic illness among children and adults from conditions such as childhood and adult asthma, diabetes, cardiovascular disease, and behavioral disorders. Key safeguards and investments encompass: (1) expanded Medicaid for both low income children and adults because of the program's comprehensive coverage and strong cost sharing protections; (2) key health care access and patient protections in all health insurance products sold in medically underserved communities in order to prevent the under-service of plan members underpayment health care providers that continue to treat the uninsured and under-insured; (3) direct investments in programs such as community health centers and the National Health Service Corps; (4) investments aimed at fostering clinical integration and partnerships among health care providers serving medically underserved communities; and (5) public health investments

Open Access