California’s Federally Qualified Health Centers (FQHCs) are key primary care providers for people with low incomes and have been expanding their capacity due to several market and policy factors, particularly the implementation of the Affordable Care Act (ACA). FQHC expansion is happening both within individual organizations, through the creation of new organizations and sites of care, and through collaborations with other providers, driven by the main goals to serve more patients, improve integration and efficiency of care, and position these providers for a potential movement to value-based payments. These collaborative strategies involve not only extending primary care capacity but also improving access and integration for behavioral health, specialty care, and social services.

The California Health Care Foundation’s longitudinal Regional Markets Study provided a unique opportunity to track FQHC capacity expansion, collaborative strategies over time, and variation across regions.

This paper focuses on collaborations among FQHCs, other safety-net providers and agencies, and some more mainstream providers (those that serve large populations of commercial and Medicare patients). It describes key examples highlighted by FQHCs and other safety-net providers, as well as market observers, from the seven regions, and discusses the motivations behind each strategy and the challenges they face.

The complete 2016 report is available under Document Downloads.

CHCF publishes a series of issue briefs that examine the health care markets in seven regions of California: Fresno, Los Angeles, Orange County, Riverside/San Bernardino, Sacramento, San Diego, and the San Francisco Bay Area. These briefs highlight the state’s changing health care systems following the implementation of the Affordable Care Act. They are published as part of the CHCF California Health Care Almanac, an online clearinghouse for key data and analyses examining California’s medical system.