Impact of the Affordable Care Act on a Community Clinic serving immigrant Latinos: The role of health policy, community needs, and gentrification on sustainability

In San Francisco, the Affordable Care Act (ACA) is expected to have profound implications for community clinics as they mobilize to enroll their uninsured patients into the new healthcare exchange system.   But just as clinics may be working to increase the rolls of the insured in their clinics, they may also be risking losing these patients to other health care providers.  In San Francisco, where gentrification has been changing the demographics of neighborhoods, community clinics are faced with the additional threat that gentrification has posed as patients with increased choices may be opting to take their healthcare needs to clinics closer to them.  This study will assess the impact of the ACA on a community clinic serving Latino immigrants in San Francisco.  Through in-depth interviews with clinic staff, Executive Board members, and community outreach workers we will assess the impact of the ACA on the clinic’s operations, strategic planning and sustainability plans.  Additionally, through an analysis of patient enrollment trends and patient satisfaction data we will be able to provide a contextual framework from which to discuss how the clinic envisions its role in a changing community.  Lastly, the study will offer an insight as to how the unique role and contribution of a community clinic to its particular target population may play a strong role in ensuring its sustainability.