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For underserved people, the primary care landscape is changing \\ By Livia Gershon T his spring, when UMass Memorial Health Care announced plans to close its two-physician Plumley Village Heath Services clinic at 116 Belmont St. in Worcester, many in the city were outraged. The clinic serves nearly 2,000 patients, many of them low-income people from sur- rounding neighborhoods who find it convenient and attentive to their specif- ic needs. For example, its bilingual staff is particularly valuable to Spanish- speakers in the area. THE NEW PRIMARY CARE Dr. Laura Sturgill consults with patient Thimi Korfuzi at Family Health Center in Worcester. P H O T O / E D D C O T E "UMass is supposed to be nonprofit," said Joyce McNickles, the secretary of the Massachusetts Women of Color Coalition, who has been advocat- ing for the clinic's patients. "Unless they're really bleeding money from community health centers, they really shouldn't be pulling out just because they're not making money." UMass CEO Eric Dickson said the reasons for the clinic closing are complicated—involving the sale of the building where it was located and the lack of appropriate space nearby—but he said it does also involve belt-tightening by the large health care sys- tem. "The market has changed," Dickson said. "If we don't change with it, we will go the way of the dodo bird. Sometimes it's incredibly painful." For low-income people, there are many barriers to receiving consistent, effective primary care, from transportation and language barriers to doctors who don't accept MassHealth, the Massachusetts Medicaid program. UMass and other big players in Central Massachusetts health care have different ideas about where blame lies for this problem. But one thing that's clear is that an increasing amount of primary care in the region is being pro- vided by organizations set up specifically with low- income and marginalized people in mind: federally qualified community health centers. Dickson argues that the overall market in Central Massachusetts has shifted as for-profit institutions 14 HEALTH • Summer 2018