Federally Qualified Health Centers (FQHCs), known interchangeably as Community Health Centers (CHCs), are considered “safety net providers,” responsible for getting care to the nation’s most vulnerable populations. Since older adults are among the nation’s vulnerable populations affected by chronic disease, many FQHCs are seeking opportunities to increase the number of older adults they serve and provide them with critical self-management services. Doing so helps FQHCs meet the Health Services and Resources Administration’s (HRSA’s) requirements to increase the volume of services provided to high-risk older adults, enabling them to sustain their 330 grant funding.
Chronic Disease Self-Management Education (CDSME) programs have been shown to activate patients so that they are more involved in their care, increase their self-efficacy, and improve a number of measures related to health status, health care, and costs. Because CDSME programs are peer led, provide a supportive environment to facilitate change, and empower patients to take charge of their health, they are well suited for helping to improve the health status of vulnerable populations. They can be particularly useful in helping FQHCs improve the health of older adults who are disproportionately affected by chronic diseases.
FQHCs are designed to be inclusive of patient involvement, patient education, and self-management support. As the safety net provider for underserved populations, FQHCs often have special relationships with their patients to address barriers to care, including lack of transportation or problems in navigating health systems to access needed services. FQHCs play an important role in encouraging patients to keep appointments, attend health education activities, and self-manage their medical conditions. These dynamics can make FQHCs good candidates for offering or making referrals to CDSME workshops.
FQHCs receive reimbursement incentives by becoming Patient-Centered Medical Homes (PCMHs). When they become recognized or accredited as a PCMH, they must have an effective Medicare/Medicaid billing infrastructure to provide sustainable services. Therefore, FQHCs are primed to serve as a unique billing partner with CDSME program providers who want to establish a reimbursement strategy to sustain CDSME programs.