Medi-Cal Explained: How Health Centers are Paid



Authors: Athena Chapman, Samantha Pellón
Year: 2022
State: CA
Website link: https://nachw.org/wp-content/uploads/2023/03/MediCalExplainedHealthCentersPaid.pdf
Publicly Available: Yes
Policy: Legislative language
Sustainable Financing: How to engage and work with Medicaid, Education to HC orgs on payment options bundled etc., Reimbursement TA for FQHCs Medicaid etc., Documentation of how CHWs can work within care teams

CommunityhealthCentersand Federally QualifiedHealth Centers in California are an integral part ofthe delivery system and provide access to care formillions in vulnerable populations. This systemis often referred to as the “safety net.” FederallyQualified Health Centers (FQHCs) are paid for thecare they provide to Medi-Cal enrollees througha complicated structure governed by state andfederal law. This issue brief examines existing com-munity health centers (CHCs) and FQHC paymentmethods in Medi-Cal. It also examines the role ofAlternative Payment Models (APMs) — financialincentives for the provision of high-quality and/orcost-efficient care — as one strategy health centerscould use to increase access, improve care, andhelp modernize the payment system for FQHCs

 



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