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Community Health Centers and Payment for Integrated Care

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Enhancing Behavioral Health in Latino Populations

Abstract

Community Health Centers (CHCs), which include Federally Qualified Health Centers (FQHCs), currently provide health care services to more than 21 million patients in the U.S., most of whom are enrolled in Medicaid. Increasingly, CHCs are transforming their practices to become Patient-Centered Medical Homes (PCMHs) with integrated behavioral health services and “wrap-around” support. This chapter examines trends in Medicaid payment reform supporting PCMH and integrated care.

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References

  • Bailit, M. (2011). Payment rate brief. Patient-centered primary care collaborative. Washington, DC: Patient-Centered Primary Care Collaborative.

    Google Scholar 

  • Buxbaum, J. (2012, August 29). Helping FQHCs get off the treadmill. Retrieved from https://www.statereforum.org/weekly-insight/helping-fqhcs-get-off-treadmill.

  • Harris, I., Marsteller, J., Kiptanui, Z., Pederson, S., Perlmutter, D., Franey, C., … Emery, D. (2015). Evaluation of the Maryland multi-payor patient centered medical home program. Columbia, MD: Maryland Health Care Commission.

    Google Scholar 

  • Heath, B., Wise-Romero, P., & Reynolds, K. A. (2013). A standard framework for levels of integrated healthcare. Washington, DC: SAMHSA-HRSA Center for Integrated Health Solutions.

    Google Scholar 

  • Hostetler, C., Sisulak, L., Cottrell, E., Arkind, J., & Likumahuwa (2014, April 14). Origins in Oregon: The alternative payment methodology project. Retrieved from http://healthaffairs.org/blog/2014/04/14/origins-in-oregon-the-alternative-payment-methodology-project/.

  • Kaiser Family Foundation. (2015). Distribution of revenue by source for federally-funded federally qualified health centers. Retrieved from http://kff.org/other/state-indicator/fqhc-revenue-by-source/.

  • Kaiser Family Foundation. (2016). Total medicaid managed care enrollment. Retrieved from http://kff.org/medicaid/state-indicator/total-medicaid-mc-enrollment/.

  • Kidney, R. (2013). Health care payment reform: State initiatives to meet the triple aim. Washington, DC: National Association of Community Health Centers.

    Google Scholar 

  • Lardiere, M., Jones, E., & Perez, M. (2011). NACHC 2010 assessment of behavioral health services in federally qualified health centers. Washington, DC: National Association of Community Health Centers.

    Google Scholar 

  • McKinney, D., Ertle, L., & Wong, W. (2014). 2014 update on the implementation of the FQHC prospective payment systems (PPS) in the states. Washington, DC: National Association of Community Health Centers.

    Google Scholar 

  • McKinney, D., Kidney, R., Xu, A., Lardiere, M. R., & Schwartz, R. (2010). Health center reimbursement for behavioral health services in medicaid. Washington, DC: National Association of Community Health Centers.

    Google Scholar 

  • McKinney, D., Kidney, R., & Burns, K. (2011). Update on the status of the Medicaid prospective payment system in the states. Washington, DC: National Association of Community Health Centers.

    Google Scholar 

  • National Association of Community Health Centers. (2013a). Key health center data by state: Federally funded health centers only. Washington, DC: NACHC.

    Google Scholar 

  • National Association of Community Health Centers. (2013b). FQHC prospective payment system: Essential to the health center model. Washington, DC: NACHC.

    Google Scholar 

  • NORC at the University of Chicago. (2011). National Association of Community Health Centers assessment of FQHC’s integrated behavioral health services.

    Google Scholar 

  • Rich, E., Lipson, D., Libersky, J., & Parchman, M. (2012). Coordinating care for adults with complex care needs in the patient-centered medical home: Challenges and solutions. Rockville, MD: Agency for Healthcare Research and Quality.

    Google Scholar 

  • Richardson, K. (2004). The bridge to 340B comprehensive pharmacy services solutions in underserved populations. Washington, DC: HRSA.

    Google Scholar 

  • Rosenbaum, S., Zakheim, M. H., Leifer, J., Golde, M. D., Schulte, J. M., & Margulies, R. (2011). Assessing and addressing legal barriers to the clinical integration of community health centers and other community providers. New York, NY: The Commonwealth Fund.

    Google Scholar 

  • Sparer, M. (2012). Medicaid managed care: Costs, access and quality of care. Princeton, NJ: Robert Wood Johnson Foundation.

    Google Scholar 

  • Steinberg, J. (2014). Advancing behavioral health integration within NCQA recognized patient-centered medical homes. Washington, DC: SAMHSA-HRSA Center for Integrated Health Solutions.

    Google Scholar 

  • Texas Legislative Budget Board. (2014). Federally qualified health centers prospective payment systems for medicaid services (ID: 1326). Austin, TX: Author.

    Google Scholar 

  • Texas Medicaid. (2015, April 14). Static fee schedules. Retrieved from http://public.tmhp.com/FeeSchedules/StaticFeeSchedule/FeeSchedules.aspx.

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Correspondence to Charles Duarte .

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Duarte, C. (2016). Community Health Centers and Payment for Integrated Care. In: Benuto, L., O'Donohue, W. (eds) Enhancing Behavioral Health in Latino Populations. Springer, Cham. https://doi.org/10.1007/978-3-319-42533-7_6

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