Trends in Days in Accounts Receivables Across Safety-Net Health Centers, 2019-2023

Area of Science:

• Health Services Research
• Health Economics
• Public Health Policy

Background:

• Community health centers are vital for underserved populations.
• Financial instability is a persistent challenge for these centers, worsened by the COVID-19 pandemic.

Purpose of the Study:

• To analyze the financial impact of the COVID-19 pandemic on community health centers.
• To assess trends in accounts receivable (AR) over a five-year period (2019-2023).

Main Methods:

• Analysis of monthly and annual accounts receivable (AR) data.
• Inclusion of data from 81 community health centers across the United States.
• Longitudinal study design covering the years 2019 through 2023.

Main Results:

• Overall improvement in Days in AR from 49.8 in 2019 to 47.5 in 2023.
• Larger health centers achieved greater reductions in AR days.
• Centers with fewer uninsured patients saw an increase in AR.
• Clinics in Medicaid expansion states maintained financial stability, while non-expansion states experienced AR fluctuations.

Conclusions:

• Community health centers demonstrated financial resilience during the pandemic.
• Factors such as center size, insurance mix, and state Medicaid policies influenced financial performance.
• Targeted financial strategies may be needed for centers serving lower-uninsured populations or located in non-Medicaid expansion states.