California Community Health Centers: Financial Analysis of Telehealth Programs
California community health centers and clinics (CCHCs), including federally qualified health centers (FQHCs), rural health centers (RHCs), and other facilities are a part of the state’s healthcare delivery system and act as safety net providers for the underserved, indigent, uninsured and rural populations. With the passage of the Patient Protection and Affordable Care Act (ACA), CCHCs are facing demand for services from newly insured individuals enrolled through the Medi-Cal expansion and Covered California. While growing evidence shows that telehealth can be an effective tool for improving access to care and improving healthcare quality and outcomes, the financial sustainability of CCHC telehealth programs is a concern.
According to the CCHCs included in this study, the key drivers for making telehealth services available to their patient populations are their commitment to provide access to needed specialty care and to fulfill their overall missions. Despite the market pressures and impetus to continue to leverage telehealth technologies, there still exist barriers and challenges to adoption. Addressing financing and payment models for telehealth is necessary to promote telehealth as part of the “new normal” in how healthcare is delivered and to ensure access to necessary healthcare services. Reimbursement mechanisms and coverage policies for telehealth services at CCHCs will change as payers seek innovative strategies to align payment to drive improvements in population health, health outcomes, and efficiencies.
This report summarizes the in-depth fiscal analysis conducted by Milliman, Inc. of each of the five community health centers (CHCs) that participated in Community Health Centers and Telehealth: A Cost Analysis Report & Recommendations, a study by PHI's Center for Connected Health Policy, which examined the cost and reimbursement barriers faced by CHCs when using telehealth to serve their clients.