Factors Related to the Use of Planned Parenthood Affiliated Health Centers (PPAHCs) and Federally Qualified Health Centers (FQHCs)

Summary

Recent debates about federal funding for the Planned Parenthood Federation of America (PPFA) and its affiliated health centers (PPAHCs) have raised questions about the services that PPAHCs provide and the availability of alternative facilities to provide similar services to a similar population. This report provides background information and data that may be useful for policymakers evaluating these recent debates. Although a number of other facility types could potentially provide similar services as PPAHCs, this report focuses on federally qualified health centers (FQHCs)—a term used interchangeably with health centers or community health centers—because these facilities have been the focus of recent legislation.

This report provides information on three central dimensions of health care. Specifically, for one health facility to begin to provide services to patients that had previously been seen at a different facility, the receiving facility must

provide similar services,

serve a similar population, and

be located in a similar geographic area.

This report provides national-level data on these three dimensions. Some selected findings include the following:

Services: Both PPAHCs and FQHCs provide family planning services; however, PPAHCs focus on providing family planning and related services, whereas FQHCs focus is on providing more comprehensive primary care, dental, and behavioral health services. There are nearly15 times the number of FQHCs than there are PPAHCs; thus FQHCs provide far more services in a given year than do PPAHCs. However, despite providing more services overall, FQHCs in total provide fewer contraceptive services than do PPAHCs. Specifically, in its 2013-2014 report, PPFA reported that its PPAHCs provided 3.6 million contraceptive services while FQHCs reported providing 1.3 million of these services in 2014. In addition, each individual FQHC provides far fewer contraceptive services than does the typical PPAHC.

Populations: Both PPAHCs and FQHCs serve a diverse, but disadvantaged population. PPAHCs focus their services on individuals of reproductive age; whereas, FQHCs provide services to individuals throughout the lifetime. FQHCs served 22.9 million people in 2014, as compared to 2.7 million served by PPAHCs. In 2014, 31% of FQHC patients were children and 8% were age 65 and over.

Locations: PPFA affiliates choose the location of their facilities. PPFA reports that the majority of PPAHCs are located in health professional shortage areas (HPSAs), medically underserved areas (MUAs), or rural areas. In contrast, FQHCs are required to be located in MUAs or to serve a medically underserved population. There is some overlap in the location of PPAHCs and FQHCs as 358 counties have both a PPAHC and a FQHC. Facility locations may be particularly important to evaluations of access because health systems and options vary considerably across states and localities. In some areas, one facility may be as accessible as another and may provide (or may be able to begin to provide) the same set of services. In other areas, this may not occur because, for example, only one provider exists, either in general or for a particular service type. Moreover, facilities located in the same geographic area may not be equally accessible for patients, as one facility may be located near public transportation routes while another may not. Although this report presents maps of locations of PPAHCs and FQHCs, these maps are not sufficient to infer meaningful information about the local health care system.