California’s Federally Qualified Health Centers (FQHCs) are a critical part of the health care safety net, providing care for communities of color, people experiencing homelessness, and others who do not have regular access to health care. It is vital that health centers are financially and operationally stable so they can continue to effectively meet the needs of the patients who rely on them for primary care, behavioral health, and dental services. At the start the COVID-19 pandemic, California’s health centers were already facing financial challenges that had put them on uncertain ground, with significant reductions in operating margins between 2016 and 2019. Once the pandemic hit, face-to-face primary care visits and corresponding reimbursements dropped precipitously. This paper identifies several key factors that enabled California’s health centers to manage the financial strain exacerbated by the pandemic while continuing to serve patients at a time when accessing health care involved new and unanticipated challenges. This paper, the second in the series, analyzes the financial impact of the COVID-19 pandemic on California health centers from March through December 2020, based on a range of publicly available as well as proprietary data, as further described in the “Data Sources and Methodology” section. It also identifies several key fac tors that enabled California’s health centers to manage the financial strain caused by the pandemic, enabling them to continue to serve patients at a time when access to health care was being curtailed due to stay-at-home orders. These findings are informed by interviews conducted in fall 2020 by Aurrera Health Group with FQHC executives and other health center experts.
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