You’ve heard it before: Federally Qualified Health Centers (FQHCs) nationwide are struggling to find enough doctors, nurses, and mental health providers.

Recent data confirms it, over 70% of FQHCs report critical staff shortages. This isn’t just busy work; it directly threatens patients’ access to care. The shortage is driven by well-known factors: rural locations with fewer candidates, tighter budgets (Medicaid-heavy payer mix), heavy patient caseloads, and provider burnout from high demand. FQHC leaders are rightly tired of the excuses. Simply restating the problem isn’t enough. What FQHCs need now are clear solutions tailored to their circumstances, not another round of handwringing.0

This report cuts through the noise by matching each root cause of the staffing crisis with concrete remedies.

We outline the scope of the shortage and why it’s especially acute in FQHCs, then focus on how to fix it. Each section pairs an issue (for example, rural recruitment challenges or retention issues) with proven or emerging strategies (such as telehealth, loan forgiveness programs, flexible staffing models, etc.). Our goal is to empower FQHC leaders with hope and practical options. Rather than lamenting what can’t be changed, we highlight what can be done now to mitigate shortages and improve care.

Widespread shortages

Majority of health centers face staffing gaps, e.g. more than 7 in 10 report not enough doctors, nurses, or behavioral health providers. These numbers have risen dramatically since 2018, even as FQHC patient rosters hit record highs (31 million served in 2023).

Telehealth as a game-changer

Telehealth adoption at FQHCs has exploded (from ~24% offering it in 2018 to 96% in 2024). Nearly all centers say virtual care lets them reach patients who’d otherwise skip care, improves timeliness (88% of centers report faster care), and even eases access to specialty consults (61% say telehealth expands specialty care reach). This shows that virtual services can directly offset provider shortages when supported by funding and infrastructure.

Tailored solutions for specific gaps

Different problems have different fixes. For recruitment, health centers can leverage federal programs (like the NHSC loan repayment and J‑1 visa waivers) that steer clinicians to underserved sites. To retain staff, FQHCs can adopt flexible hours, remote work options, and wellness supports reducing burnout and turnover. Remote staffing models (e.g. per-diem or part-time providers, nurse triage lines, and even remote scribes) have proven effective for many centers.

Policy and funding fixes are critical

Current payment policies disadvantage FQHCs. For instance, unequal Medicaid telehealth reimbursement has caused centers to lose behavioral health staff. One study found some FQHCs lost up to 40% of their mental health team when remote visits pay lagged. Closing such gaps (ensuring payment parity, extending pandemic flexibilities) is essential. Likewise, stable federal funding (like a reauthorized Health Center Fund) underpins all local solutions.

Successful case examples

Some FQHCs have already turned the corner by innovating. For example, a rural West Virginia FQHC deployed a robust telehealth and remote monitoring program in 2020. By allowing providers to see patients from home and using digital tools to manage chronic care, they alleviated staff burnout and expanded their capacity. (This shows that technology + creative staffing can amplify a small workforce.)

Yes, we know this topic has been beat to death in the industry. But this time is different because we are focusing on solutions.

The staffing crisis at FQHCs is real and widespread, but it is not hopeless. By aligning specific strategies with each challenge, health center leaders can take meaningful steps now. Expanding telehealth services, tapping federal recruitment/retention programs, offering flexible work arrangements, and improving billing/policies all have documented benefits. Implementing even a few of these measures can significantly ease provider shortfalls. FQHCs have navigated tough challenges before; with the right tools and commitment, they can do it again.

In the accompanying in-depth article, we:

Frame the crisis: Examine national survey data on how severe FQHC staffing shortages are, including breakdowns by provider type.

Diagnose causes: Explore why FQHCs have such a hard time recruiting and keeping staff, from geographic isolation and funding constraints to burnout from heavy patient loads.

Match solutions to causes: Detail targeted remedies. For recruitment gaps, we discuss loan repayment programs, residency pipeline building, and other federal incentives. For retention and capacity, we cover flexible scheduling, telework, outsourcing (like tele-triage nurses), and team-based care models. We also delve into the technology side: enhancing telehealth platforms, remote patient monitoring, and digital tools that extend a provider’s reach.

Policy actions: Review necessary policy fixes (e.g. telehealth reimbursement parity, stable grant funding) that make these solutions viable.

Case examples: Illustrate with real-world FQHC stories (like the WV center above and others) how creative strategies can pay off.

Key recommendations: We summarize steps FQHC leaders can take immediately and advocate for (both locally and at the federal level).

We support FQHCs in delivering integrated medical and behavioral care. When providers are in short supply, the clinics we serve struggle to meet patient needs, including the behavioral health care that is at the heart of our mission. This shortage directly impacts the success of FQHCs' patient care outcomes. We wrote this report because our partners’ challenges are our challenges. By highlighting practical solutions and advocating for systemic fixes, Peregrine affirms its commitment to FQHC sustainability. In short, solving the provider shortage is not just an industry issue, it’s central to Peregrine’s goal of empowering health centers to care for every patient in need.