When you think of healthcare innovation, you may think of artificial intelligence (AI)-powered medical devices that can diagnose diseases quicker than a doctor or devices that can regenerate bone after surgery.
But if you ask Kyu Rhee, president and CEO of the National Association of Community Health Centers (NACHC), the “most innovative part” of the healthcare system is one that’s already been around for 60 years: community health centers (CHCs).
Established in 1965 as part of President Lyndon B. Johnson’s War on Poverty, CHCs provide primary healthcare services including chronic disease management, cancer screening, dentistry, behavioral health, and more to patients regardless of whether they can pay or are insured.
Today, CHCs treat nearly 1 in 10 people across the US. As head of NACHC, which represents the roughly 1,500 CHCs across the US, Rhee has big plans to expand that number to 1 in 3.
“I do believe when you look at the broader system, there’s no better model of primary care,” Rhee said. “Our model is very focused on those communities that need us the most, and in many ways, it’s defined by people who are low income or poor.”
The ABCs of CHCs
Rhee took the helm of NACHC in July 2023 after a healthcare career spanning both public and private roles, including chief medical officer of CVS Health’s Aetna division and chief public health officer at the Health Resources and Services Administration, a division of the Department of Health and Human Services that focuses on providing care to vulnerable populations.
Rhee told Healthcare Brew he took the role as president and CEO of the nonprofit organization because he thinks, in addition to being the most innovative, CHCs are the best and “most resilient” part of the healthcare system.
Part of what makes them so is the fact that they “save lives and save money,” he said.
Though CHCs treat about 10% of the US population—that’s nearly 34.7 million people—they only cost about $55 billion, or 1% of all healthcare spend, according to NACHC. That’s because they’re efficient, affordable, and local, according to Rhee.
Plus, CHCs are required by law to be nonprofits and serve their communities, so they can’t be scooped up by giant for-profit corporations like Optum or CVS Health.
Another factor that keeps costs low, Rhee said, is that CHC boards are required to be made up of at least 51% patients, meaning the people they treat get a say in how the clinics are run.
No small feat
However, it’s not easy to treat so many people while keeping costs down.
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The two biggest challenges on Rhee’s mind at the moment are Medicaid cuts and workforce shortages, he said.
The NACHC says half the patients treated at CHCs are on Medicaid, which Rhee calls the “lifeblood” of the clinics. CHCs get roughly 42% of their revenue from the public payer, “so we need Medicaid to be protected in order to do the work that we do in saving lives and saving money in communities across this nation,” he said.
The Trump administration’s One Big Beautiful Bill, which was signed into law on July 4, reduces federal Medicaid spending by an estimated $990 billion over 10 years, according to KFF.
Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County—which represents the more than 450 CHCs serving about 2 million people across the region—told Healthcare Brew the organization is bracing for “seismic shifts in the healthcare landscape in Los Angeles and beyond” because of the cuts to Medicaid.
“We’re looking at 3.4 million Californians falling out of coverage, and an estimated loss of $30 billion in federal funding for California,” McCarthy said. “If these folks don’t have coverage, how are we going to get them access to specialty care, to hospitals? We’re probably going to see a lot of hospital closures, and we won’t have places to send our patients.”
Staffing is also a big challenge, Rhee said, noting CHCs typically have a team of 10 providers to treat 1,000 high-need patients, who often live below poverty level.
McCarthy echoed that sentiment, saying it’s “really, really hard” as a nonprofit to “recruit and compete against larger, more resourced organizations.”
Triumphs and ambitions
Though he’s only led NACHC for a short time, Rhee already scored a major win in March 2024 when CHCs received the first increase in federal funding in nearly 10 years, bringing the total to $4.4 billion annually.
Rhee said he considers this one of his biggest accomplishments during his tenure at the nonprofit.
“The fact that we’ve been nonpartisan and gotten bipartisan support is part of what I’m very proud of in my first couple years at NACHC,” he said.
Looking ahead, in order to meet NACHC’s goal of treating 1 in 3 people by 2045, “we need funding, we need workforce…we need to protect Medicaid,” Rhee said.
“We need to demonstrate that we’re a core part of making America healthy.”