Medi-Cal ExplainedThis issue brief is part of CHCF’s Medi-Cal Explained series. The series provides an overview of the program, including the people it serves, the services it provides, and how it is organized, managed, and financed. |
Community health centers provide primary and preventive care to millions of Californians, especially those with low incomes.
Community health centers is a broad term referring to community-based health care organizations that deliver comprehensive and culturally competent primary and preventive care services to California’s medically underserved populations without regard to a patient’s ability to pay for care.
Federally Qualified Health Centers (FQHCs) are a specific type of community health center and are paid for the care they provide to Medi-Cal enrollees through prospective payment system reimbursement, a complicated structure governed by state and federal law.
This issue brief examines existing community health center and FQHC payment methods in Medi-Cal, including the prospective payment system. It also includes a high-level overview of alternative payment models — financial incentives for the provision of high-quality and/or cost-efficient care — as one strategy to help modernize the payment system for FQHCs. An appendix outlines an emerging Medi-Cal initiative known as FQHC APM 2.0.
This paper is a companion to a second CHCF publication, Medi-Cal Explained: What Are Alternative Payment Models?