California Federally Qualified Health Center Alternative Payment Model: Implementation Guide



Authors: Greg Howe; Karla Silverman MS, RN, CNM; Rob Houston, MBA, MPP
Year: 2023
State: CA
Website link: https://nachw.org/wp-content/uploads/2023/04/CA-FQHC-APMImplemGuide-Mar-2023.pdf
Publicly Available: Yes
Evidence Generation: Documentation of how CHWs can work within care teams, Evidence-based interventions
Policy: General language around CHW WD
Sustainable Financing: Expand evidence base, General other, How to engage and work with Medicaid, Education to HC orgs on payment options bundled etc., MCO or bundled payment reimbursement models, Reimbursement TA for FQHCs Medicaid etc., Documentation of how CHWs can work within care teams, Evidence-based interventions
Workforce Development: Data sharing between social services and clinical teams, General other (including mention of “employment practices”)

The California Federally Qualified Health Center Alternative Payment Model (FQHC APM) is a proposed initiative of the California Department ofHealth Care Services (DHCS). The FQHC APM is designed to move away from the traditional fee-for-service (FFS) payment system, which rewards the volume of services provided, to a model that rewards high-quality and cost-effective care that is coordinated, team-based, convenient to access, and best meets patient needs. This guide includes practical resources for reimagining and redesigning how the FQHC delivers care so it can be successful in the FQHC APM.



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