To review the neurology care provided at the first Federally Qualified Health Center (FQHC) based neurology clinics.

The Federal Qualified Health Center (FQHC) program is a reimbursement designation from the Bureau of Primary Health Care and the Centers for Medicare and Medicaid Services. They are community-based organizations that provide services including comprehensive primary care and preventive care, regardless of ability to pay.

Patients seen from August 31, 2016 until March 31, 2018 were reviewed.  The geographic area, diagnosis, number of unique patients, frequency of patient visits, patient experience questionnaires and payer mix were reviewed.  A survey of resident experiences at SACHs was compared to other educational sites, assessing the learning environment, diversity of patient cases, and ancillary staff.

1485 total patients and 823 unique patients were evaluated. The return visit rate was 73% and the no show rate overall was 20%. 24% of patients were ages 21-30, 20% ages 31-40, 17% ages 41-50, 19% ages 51-60, and 12% ages 61-70.  Wait times to be seen in clinic were < 10 minutes for 34% and < 20 minutes for 54%.  Patients traveled as far as 160 miles for appointments.  Of patients who completed patient satisfaction surveys, 100% would recommend the clinic to their friends and family. 86% of residents reported that they were satisfied with their experience at SAC clinic. Satisfaction with the clinical and educational environment, time allotted for appointments, faculty mentorship, ancillary staffing, number of patients seen, relationship and continuity with patients, availability of clinical services, and personal reward from work performed at clinic were also rated. 

Specialty care in neurology that is valued by patients and neurology residents can be provided in the FQHC setting. This can allow neurology care to be provided to populations of patients who otherwise may encounter barriers in accessing care.