There’s a common misconception that federally qualified health centers and community clinics are providers of last resort. But when you look at the numbers and health outcomes, FQHCs are leading the charge in high-quality healthcare with important lessons about delivering value and adapting rapidly, especially during COVID-19.
In lower-income and rural areas especially, access to healthcare services is scarce. The mission of these centers is to serve the underserved and reach populations that don’t otherwise have access to high-quality healthcare, including behavioral health, women’s health, pediatrics, primary care and social services.
As medical practices and health systems adapt for a post-COVID-19 world as well as changes in insurance coverage and value-driven financial models, we know as healthcare leaders that we’ll all have to be doing a lot more with a lot less. That’s a world that FQHCs know well, and we’ve found some keys to success along the way:
Deliver care where patients need it. Across healthcare, we’ve quickly learned how important telemedicine is for patients right now, but how about care in other nontraditional settings for the “new normal”? Patients need variety and flexibility. We need big clinics and small clinics. We need to be inside hospitals, in schools, in mobile units. The dramatic technology and parity reimbursement innovations of the past several months means that we can all re-imagine what it means to go where our patients need us to be.
Get proactive with real-time data. In order to improve health outcomes and meet value-based care metrics, healthcare organizations need to know in real time when their patients are in need. Joining a health information exchange is one way to achieve this. My FQHC, in Southern California, is part of Manifest MedEx, a not-for-profit statewide exchange, that notifies us immediately when one of our patients is hospitalized or discharged. Our case managers log in first thing every morning to reach out and get patients back into the clinic for post-hospital visits. That makes a difference. Patient health is improving and readmissions are declining. Patients appreciate that someone is reaching out and showing they care.
Respond quickly to changes in patient needs. Most medical providers saw a sharp decline in patient volume at the start of the pandemic. Many private, boutique and concierge medical providers were closing their doors. In my community, with these clinics suddenly not available, and a lack of testing services in our areas, we saw the need shift. We rapidly put together a clinic command center and a task force. We quickly turned 17 of our sites into COVID-19 testing centers and added telehealth capabilities, a triage hotline and increased behavioral health access. We put together pop-up events to support people in communities that had especially difficult access to testing. Because health centers are in so many U.S. communities, they play a critical role in delivering care during times of public health crisis.
Make data-sharing a priority. COVID-19 has further underscored the critical need for data-sharing. It’s vital that healthcare organizations have direct access to lab results, hospitalization data and longitudinal records without having to request information manually every time it’s needed. We use our health information exchange instead of endless faxing and phone calls. When data is readily available, it makes collaboration much easier. Efficiently sharing data with other healthcare organizations is crucial for not just community health centers, but all providers.
Invest in a culture of action. You can’t just ask people to change, it has to be a priority in your organization. You need to adapt and adjust to meet clients’ needs. The way you do this is by listening to your workforce and your community. While the shift to value-based care comes with complexities for many organizations, it also can be a way to simplify and refocus on what really matters most to patient health. Is your team ready to give up ideas of “the way it’s always been done” in exchange for new energy about “the way we can do things differently”?
Between the pandemic, the shift to value-based care, new regulations and more new policies ahead, we are all thinking more flexibly about the future. FQHCs may have a bit of a head start. We’ve been working in an intensely value-focused part of healthcare, at a time when our sector is more intensely looking at value. We’re not that special though. Any healthcare organization can test and try new programs like we’ve outlined here. The telehealth boom has already helped so many organizations realize they can deliver care in new ways.
Starting next year, most hospitals will have to share notifications on patient transitions under a new CMS rule. That means more clinics and providers will have the ability to get proactive and collaborate using health data. A culture focused on action and an agile response to what patients need and where they need it is hopefully going to be part of the new normal for healthcare.