FQHC Employee Churn & Shortage Crisis by the Numbers
- John (JD) Donnelly
- 11 minutes ago
- 3 min read
Plus a New Automated Workforce Strategy and Automation to Help
Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs) are doing something no health system should have to pull off: serving record numbers of patients with a shrinking, exhausted workforce.
On paper, the model is working.
The Health Resources and Services Administration (HRSA) reports that health centers served over 31 million patients in 2023, and more than 32.4 million in 2024, the highest in the program’s 60-year history.
The National Association for Care at Home (NACHC) notes that CHCs now care for about 1 in 10 people in the U.S., with more than 32.5 million patients and over 310,000 staff across 16,000+ sites.
This seems to fulfill the mission side of “no margin, no mission.” The margin side is where things get ugly.
Let’s look at the data:
FQHC Churn, Staff Shortages & Vacancies
Over 70% of FQHCs are facing critical shortages in physicians, nurses, and mental health providers, with vacancy rates over 20% in many core roles.
Staff vacancies in revenue cycle functions are widespread: one survey found that 80% of organizations’ turnover in revenue cycle management staff was between 11–40%.
FQHC Staff Turnover
Frontline roles like medical assistants turnover at nearly 1 in 4 per year, and administrative teams saw more than 22,000 departures in a single year across CHCs. (see below)
Even before COVID, CHCs were losing 5–25% of their workforce in just six months, with another 15% losing as much as half their staff.
NACHC’s workforce blog shows annual turnover rates that would make any CFO’s eye twitch:
FQHC Funding Cuts
Additional layoffs are anticipated due to static funding, and potential impact from the One Big Beautiful Bill, slated to cut Medicaid funding by up to $1 trillion.
Without fast action Medicare funding could reduce by $500 billion between 2026 and 2034.
What's the cause of FQHC churn?
These exit numbers are staggering. What is the root cause of such a high churn volume?
Salary – Competition from other employers tops the NACHC’s list with 65% of CHC’s reporting that employees left for better financial opportunities and up to a 25% increase in salary.
Burnout – Sure, burnout is difficult to quantify, but thin margins combined with increasing demand in sometimes life-threatening environments equates to tangible stress. Burnout can’t be dismissed as a cause.
The NACHC sums it up:
CHCs serve at least 1 in 10 Americans, yet account for only 1% of total U.S. healthcare spending, saving Medicaid and Medicare billions annually by reducing costly emergency, inpatient, and specialty care. However, CHCs are struggling to recruit and retain enough staff due to provider shortages, competitive salary gaps, and persistent burnout among health care workers, resulting in CHC patients going without needed care.
What can FQHC and CHC leaders do?
Let’s be clear, this is a systemic national problem. It may be worsening, but it’s certainly not new. So, do what you know works:
Protect the people you already have. Do this by being brutally honest about workload. Track productivity, vacancy, attrition, and burnout signals. The NACHC recommends boards monitor staffing challenges directly alongside financials. We found this helpful resource: Tips for Boards on Health Center Workforce Challenges and Opportunities
Workforce strategy must be a core KPI. Build workforce strategy and analytics into leadership performance goals. Consider including employee pipeline, retention, and workforce wellbeing into budget planning.
Automation and consistency! Strip out duplicative work and responsibly automate anything that saves your staff time. Eligibility checks, demographic verification, state assistance are just some examples of what FrontRunnerHC can take off your plate.
Is automating FQHC and CHC workflows the answer?
Yes. Automation is a safety net. It builds a system that won’t collapse even when people churn. With technology carrying the weight, your people can focus on patients, not paperwork.
An automated eligibility-verification engine, for example, runs the same checks every time. It doesn’t forget to run a secondary search. It doesn’t skip a payer rule. It captures the documentation, flags gaps, and routes for correction.
Because the logic lives in the system (not in someone’s head), your process becomes more resilient to changes in personnel.
When new staff arrive or cover for absences, they plug into existing flows. They see what needs attention (e.g. missing documents, flagged accounts). There’s no need to reinvent triage.
Automation also standardizes decision-points and enforces guardrails (e.g. “don’t send this claim until verification is validated”). So even with turnover, your revenue cycle won’t jackknife under load.
Real results for FQHCs and CHCs
If maintaining revenue in the face of staffing churn feels impossible, you’re not wrong. But the data proves that a “doing more with less” mentality will never be sustainable.
FQHCs must make workforce strategy a non-negotiable and integrate tools to support that strategy. Successful FQHCs are already automating workflows, instantly accessing accurate data, and identifying coverage before care. The margin and cost-savings results are astounding.
Don’t believe it’s possible?
Discover how FrontRunnerHC helped Watts Healthcare, a Los Angeles-based FQHC, slow staff churn and increase margin with an annualized revenue of over $6 million.
FrontRunnerHC helps improve FQHC workflows with fast, accurate data, automated state assistance discoverability, and complete athenahealth integration. Learn more.