Essential Community Provider

An Essential Community Provider (ECP) is a health care provider that serves predominantly lower-income, medically underserved individuals and families.

Criteria for ECPs were developed by the U.S. Department of Health and Human Services (HSS) and the Centers for Medicare and Medicaid Services (CMS) for Qualified Health Plans (QHPs) under the Affordable Care Act (ACA).

Under the ACA, a QHP is an insurance plan that:

  • Is certified by the Health Insurance Marketplace;
  • Provides essential health benefits;
  • Follows established limits on cost sharing; and
  • Meets other requirements outlined in the application process.
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