Risky business: California health centers weakened by the COVID-19 pandemic prepare for the future
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (California HealthCare Foundation)
- Author(s):
- Backstrom, Carol, author Block, Lauren, author Coleman, Allison, author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, CA] : California Health Care Foundation, June 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Community Health Centers COVID-19 California United States
- Genre(s):
- Technical Report
- Abstract:
- The COVID-19 pandemic has had a profound impact on the entire health care delivery system. For Federally Qualified Health Centers (FQHCs),1 which are foundational to the nation’s primary care safety net, this was especially true. The core mission of health centers is to provide primary and preventive care to low-income and underserved populations. Many health centers have expanded services to offer both behavioral health and oral health care services. In 2020 alone, California’s health centers provided care to 7.4 million patients, or one in five Californians. In response to the COVID-19 pandemic, health centers quickly adapted care models and operations, repurposing staff, providing outreach, leveraging telehealth modalities, and remaining open for emergencies. The pandemic reinforced that FQHCs are nimble and can reach patients in creative ways. As face-to-face visits (the primary mechanism for FQHC reimbursement) declined during the pandemic, however, health centers faced a particularly challenging time financially. The financial stability of health centers is an important consideration given that their programming benefits patients and the Medi-Cal program by supporting access, advancing health equity, and working toward broader population health. The COVID-19 pandemic demonstrated how the current FQHC payment methodology is an increasingly outdated payment model that is ripe for change. New financial analysis reveals that — whether measured by revenue, number of patients, or number of sites — the largest health centers in the state bore the brunt of the financial losses directly resulting from COVID-19. In addition, those that offer the broadest array of services — health centers that are trying to meet the medical, dental, mental health, public health, and social service needs of the community, including large and mid-sized entities - were the organizations disproportionately impacted. Health centers that serve the highest proportion of MediCal patients sustained almost all the financial losses. The Health Resources and Services Administration (HRSA) has awarded more than $1 billion to 175 California health centers through American Rescue Plan Act Awards. The combination of federal relief funding paired with temporary policy changes, such as allowing for expanded reimbursement for telehealth services, provided a lifeline that helped FQHCs remain afloat and should help cover a significant portion of prior losses and new costs. In the coming months and years, it will be important to monitor the financial health of FQHCs and the safety-net health care system. However, temporary federal relief and policy changes do not solve the root issues that caused health centers to be so vulnerable in the face of the pandemic. Because health centers serve mostly people with low incomes and communities of color, it is important to ensure that health centers’ operating model is less vulnerable to fluctuations in in-person visit volume. During the pandemic, such fluctuations led to downsizing and temporary closures at 13% of California’s FQHC sites. Such trends threaten access to care and health equity. This report summarizes policy options that have the potential to improve FQHC stability, address health equity, and ensure access to a broader range of services in the long term, including the following: (1) Modernizing payment to FQHCs through an alternative payment model (APM) (2) Recognizing the value of all telehealth modalities, including telephone calls (3) Making investments in the health care workforce.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (11 pages)).
- NLM Unique ID:
- 9918366885606676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918366885606676