Investing in the Primary Care Front Line: Why CHCs Need Workforce Investment Now

Community Health Centers (CHCs) serve 32.5 million people, or 1 in 10 nationally, providing care in the communities that need it most. This frontline primary care system employs more than 310,000 staff nationwide, spanning physicians, nurses, behavioral health professionals, enabling services providers, and essential administrative and support roles. However, CHCs are facing a major workforce crisis, with significant vacancies and staff turnover that threaten their capacity to meet demand for primary care.

According to a 2025 NACHC staffing survey (of select positions), approximately 26% of certified nurse midwife positions were vacant, amounting to roughly 300 unfilled roles nationwide. Other core services also reported alarmingly high vacancy rates, including vision care, physicians, behavioral health providers, dental hygienists, and dental assistants, each hovering around 20% or 21%.

In terms of estimated vacancy counts, behavioral health positions had the largest shortfall, with an estimated 5,300 unfilled postions. This was followed by 2,800 vacancies among physician assistants (PAs) and nurse practitioners (NPs), 2,000 open physician roles, and 1,400 pharmacy vacancies.

Staff vacancy is only part of the problem. High turnover across various job categories is compounding the challenge of maintaining care continuity and quality of care. Medical assistants experienced the highest turnover rate at 24%, followed by dental hygenists and assistants at 18%, and both administative staff and registered nurses at 15%. In terms of estimated volume, administrative roles saw the highest churn, with an estimated 22,600 staff departures in a single year. Behavioral health staff followed with 3,700 departures, along with 3,000 PAs and NPs, and 1,700 physicians.

These figures reflect a deepening strain on the CHC workforce, one that affects both access to care and the ability of CHCs to sustain integrated, team-based models that are foundational to primary care. Without targeted investment in workforce pathways and pipelines, retention strategies, and supportive infrastructure, the CHC model, which has long been a backbone of care for high-need communities, risks being stretched beyond its limits.

The crisis is not only about staffing levels. As demand grows, care becomes more complex, the envrionment in which staff work is under increasing pressure. Practice transformation, expanded expectations, and the demands of health information technology have introduced new burdens and shift workflows. Even well-intentioned innovations can add administrative burden or disrupt workflows if not supported with the right infrastructure.

CHCs need sustained investment in streamlined care delivery models, opportunities for professional development and a workplace culture rooted in trust, teamwork, and mission alignment. A bold investment in a resilient and supported workforce is essential to the future of primary care.

Filed under topic(s): Workforce