January 31, 2026

Why Utilization Is a Trust Problem, Not an Access Problem

FQHC leaders are right to focus on utilization.

More appointments.

More patients returning.

More consistent care.

What often gets missed is what comes before that.

In this conversation, Jane Pfeiffer and Hannah Roth walk through what their research with thousands of FQHC leaders revealed about utilization, visibility, and value. And why utilization rarely improves on its own.

They talk about what happens when communities do not fully understand FQHCs. How low visibility quietly shapes perception. And how being undervalued shows up in patient behavior long before it shows up in the schedule.

This is not a conversation about access alone.

It is about trust. How trust is formed. How trust is transferred. And how it is lost through small, everyday experiences that are easy to overlook when teams are stretched thin.

Jane and Hannah share why focusing only on utilization can backfire. And why addressing visibility and value first creates conditions where utilization can actually change.

For FQHC leaders trying to understand why patients do not return, this conversation helps surface what is happening before the appointment is ever made.