Key Takeaways
- Medicare readiness varies among California community health centers (CHCs), and gaps mean some are leaving potential revenue unclaimed and missing opportunities to effectively serve and retain older adult patients.
- Improving data infrastructure and standardizing and streamlining workflows are key to optimizing both clinical and financial performance in Medicare.
- As more CHCs are prioritizing Medicare, staff training and support are essential elements of long-term financial sustainability and better care for older adults.
As nearly 10 million Californians are projected to be 65 and older by 2030, community health centers (CHCs) face mounting pressure to adapt their care delivery, operations, and billing practices to effectively serve a growing Medicare population.
California’s Medicare landscape is also growing more complex, with the rollout of Dual Eligible Special Needs Plans, expanding Medicare Advantage enrollment, and ongoing federal threats to Medi-Cal funding placing new operational and financial demands on CHCs — often without the infrastructure needed to meet them.
Drawing on surveys and interviews with 24 California CHCs, this issue brief identifies opportunities and interest in improving Medicare readiness — including refining billing practices, increasing use of data to inform payer engagement, and developing staff knowledge and skills to serve older adults — that can support both the financial sustainability and care quality of these essential safety-net providers. The brief offers actionable strategies to help CHCs strengthen care management, optimize data infrastructure, standardize workflows, and build the Medicare expertise needed to retain older adult patients and thrive in an increasingly complex health care landscape.
