Health Care


Individuals without health insurance are generally sicker, poorer, and less able to support our economy, their families and communities. Without reliable access to a medical home, individuals with acute pain or other symptoms are more likely to use emergency departments, ultimately raising the cost of care across the health care system. Even in communities where safety net providers exist, they can be challenged to recruit and retain providers.  Close to 200 new providers will be needed by 2020 to fill the gap between the number of physicians currently working in North Carolina and the estimated need.

Strategy: Access to Care

Free clinics, community health centers and other safety net providers with a mission to provide health care to the uninsured all help low-income and uninsured North Carolinians manage their chronic conditions, ultimately improving quality of life and reducing unnecessary use of emergency departments. We seek to increase capacity at existing safety net organizations to promote economies of scale and to support the long-term sustainability of these core organizations. Investments in equipment and other capital are prioritized when they support both access and quality of care as well as long-term financial viability. Our strategy also works to increase workforce commitment to and competence in providing care to underserved populations through community-based training programs. We support programs that increase collaboration across specialties (such as primary care and dental) and encourage the work of provider teams working at the top of their training and licensure.

Grantee Spotlights

North Carolina Association of Free and Charitable Clinics (NCAFCC)

We have a longstanding relationship with the North Carolina Association of Free  and Charitable Clinics (NCAFCC) and its members having made grants totaling more than $26M over more than twelve years. Initially focused on increasing the number of free clinics across the state and later on quality outcomes and business models, the Foundation’s grants to the NCAFCC have also provided support in the form of matching grants to underserved communities to develop new clinics and operating grants to member clinics based on quality outcomes. Today, NCAFCC provides technical assistance to 68 member clinics that deliver primary, acute care, specialty and dental care as well as pharmacy services to approximately 90,000 North Carolinians. NCAFCC’s nationally recognized approach to documenting and improving patient outcomes has demonstrated that many of our state’s free clinics provide care on par with other providers and that 76 percent of surveyed patients report a decrease in their hospital admissions since becoming a free clinic patient.

North Carolina Community Health Center Association Informatics Center (NCCHCA)

The state’s network of community health centers, all of them nonprofit community-based health care organizations providing care to underserved populations, are delivering care to more than 450,000 North Carolinians, more than half of them uninsured and 70 percent living below the poverty line. By developing the capacity to transmit electronic medical record data to and from an informatics center, the North Carolina Community Health Center Association ensures that community health centers retain access to and control of their financial, clinical and patient experience data as the health care environment evolves. Work done to-date has positioned all 34 of North Carolina’s community health centers to be connected to the state’s Health Information Exchange and has served as a catalyst for collaboration between different types of safety net organizations.

UNC Family Medicine Teaching Health Center

Studies demonstrate that residents who train in rural and safety net environments are four times more likely to work in those settings after graduation. To increase the likelihood that North Carolina family medicine residents will embark on careers serving underserved populations, we supported the development of the state’s first Teaching Health Center. The residency is a partnership between an existing family medicine residency program and Piedmont Health’s Prospect Hill clinic. Each year two UNC family medicine residents are added to the roster of physicians at Prospect Hill, increasing access to care in the community and offering residents a truly team-based training environment.