Federally Qualified Health Centers

Historically, Federally Qualified Health Centers (FQHCs) have used telehealth to address geographic, economic, transportation and language barriers to health care access.  However, FQHCs existed in a policy environment that created numerous barriers to the full adoption of telehealth technologies.  Adoption of telehealth by health centers exploded as a result of the Public Health Emergency (PHE).  Policy changes opened the door for health centers to provide comprehensive services to patients through the use of digital tools.

The National Association of Community Health Centers in collaboration with the National Consortium of Telehealth Resource Centers worked together on a pilot project to provide technical assistance to health centers who are determining how and if they will sustain telehealth operations and virtual modalities coming out of the PHE.  One resource that was developed was the Environmental Scan of Telehealth Technical Assistance Resources for FQHCs: Curated list of top telehealth technical assistance resources for FQHCs in each of the following eight categories:

1. The Digital Divide - access, broadband, equity
2. Implementation & Operations - workflows, procedures, platforms
3. Quality Assurance - measurement, data collection, improvement
4. Data & Reporting - definitions, taxonomy, EHR alignment, reporting, systems/process
5. Policy, Financial Reimbursement & Legal - advocacy efforts, regulatory surveillance
6. Patient Engagement - patient education, navigation, outreach, technical support
7. Clinical Delivery - clinician-focused services, CME/CEU, clinical skills, competencies
8. Financial Models - balancing service & payer mixes, reimbursement implications

Following are a few highlighted resources from that document .  To see all the resources, download the document!

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Telehealth Policy, Financial Reimbursement and Legal Resources for FQHCs:

• Center for Connected Health Policy Resources:
  • Telehealth Policies and FQHCs Factsheet
  • E-Consult Trends Across Medicaid Programs and Impact on FQHCs
• CMS Resources:
  • CMS FQHC Resource Page 
  • CMS RHC and FQHC Medicare Benefit Policy Manual Chapter 13 Update - January 2023
  • RHCs and FQHCs: CMS Flexibilities to Fight COVID-19 -February 2023
  • COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing - Revised April 20, 2023 
• CMS Medicare Learning Network Resources:
  • Mental Health Visits via Telecommunications for Rural Health Clinics & Federally Qualified Health Centers - Revised May 23, 2023 
  • New and Expanded Flexibilities for RHCs and FQHCs During the COVID-19 Public Health Emergency - Revised May 12, 2023 .
• HRSA Resources:
  • Optimizing Virtual Care (OVC) Biannual Briefs share key lessons learned and insights from OVC awardees across the national:
    • Preparing for Launch: Early Lessons Learned from Health Centers on Staffing and Patient Engagement for Virtual Care - April 2023
    • Preparing for Launch: Early Lessons Learned from Health Centers on Selecting New Technology and Tools for Virtual Care - April 2023
    • Accessing Virtual Care: Insights from Patient Use of Real-Time Telehealth at Health Centers Optimizing Virtual Care - April 2023
  • HRSA Program Assistance Letter: Telehealth and Health Center Scope of Project (PAL 2020-01)
  • Telehealth and Health Center Scope of Project:  Highlights relevant considerations for health centers providing in-scope services through telehealth.
• HHS Billing Medicare as a Safety-Net Provider: Highlights key areas specific to RHCs and FQHCs.
• NACHC Resources:
  • CMS Billing Lingo, Defined!
  • NACHC Telehealth Documentation and Documenting Telehealth E/M Visits: Easy to read one pager with highlights and tips.
  • Reimbursement Tips: Remote Physiologic Monitoring (RPM) & Remote Therapeutic Monitoring (RTM): This Tip Sheet provides FQHCs with simplified, easy-to-understand instructions for providing and billing CMS for RPM and RTM services.
  • Summary of Medicare Care Management Services Billed Using G0511

 

Telehealth Program Development Resources for FQHCs, most of which are also found in the Environmental Scan Resource Document!

• California TRC Sample Telehealth Sustainability Worksheet: This is a basic "calculator" tool to assist FQHCs with basic business model development using a model of purchasing blocks of time by the hour for specialty care or primary care providers.
• Experiences of Health Centers in Implementing Telehealth Visits for Underserved Patients During the COVID-19 Pandemic: Results from the Connected Care Accelerator Initiative:  Research report by the RAND Corporation looking at utilization, impact on access to care, the experience of leadership and promising practices.
• FQHC Telehealth Resources Collection: Curated resources including videos, webinars, infographics and fact sheets specific to FQHCs.  A few highlights  from  this  collection  include:
  • Community Health Centers' Telehealth Promising Practices: Case Studies from the COVID-19 Pandemic.
  • Telehealth Optimization Quick Guide for Health Centers
  • Strategic Investments in Telehealth and Digital Tools for Health Centers: Maintaining Your Competitive Advantage Beyond the Pandemic
  • Telehealth Taxonomy for FQHC Data Capture
  • Telehealth and Virtual Services: A Guide for FQHCs and RHCs
  • Recorded content from the three session FQHC Webinar Series:
    • Part 1: Telehealth and Chronic Care Management
    • Part 2: Using Telehealth to Treat Substance Use Disorder in a CHC Setting
    • Part 3: Telehealth and Mental/Behavioral Health
• Health Center Resource Clearinghouse Telehealth Learning Bundle: Gain a background understanding of the changing telehealth landscape, learn about telehealth priority areas and access resources and tools.
• Health Center Resource Clearinghouse COVID-19 Resources - Telehealth: Curated collection of resources on telehealth.
• HITEQ Telehealth & Telemedicine Resources: Curated resources and tools on telehealth and telemedicine.
• School-Based Telehealth Playbook: This Playbook guides health centers through the design, implementation and operation of a telehealth program that meets the needs of children and adolescents.
• Telehealth Playbook: Developed by the FQHC Telehealth Consortium, this how to-to guide supports adoption and sustainability of telehealth at health centers.
• Transform Virtual Care: A Step-by-Step Guide to Integrate Patient Self-Care Tools into Virtula Care (April 2021):  This guide draws on the experience of 20 health centers across the country participating in NACHC’s Leading Change: Transforming At-Home Care pilot project. NACHC offers this guide as a framework for health centers to design at-home patient care strategies based on the models, lessons, and experiences learned to-date.

 

Telementoring and Clinical Support Resources for FQHCs:

• Weitzman ECHO:  Community Health Center, Inc. was the first Federally Qualified Health Center (FQHC) to operate its own Project ECHO® clinics. Weitzman ECHO clinics are specifically designed to meet the needs of safety net primary care providers and their communities.  CHC conducts Weitzman ECHO sessions for multiple specialties and provides nationwide access for individual health centers as well as larger entities.
• Safety Net Connect:  In response to COVID-19, Safety Net Connect is offering primary care physicians free access to a dedicated eConsult platform providing electronic specialist triage and advice, often in less than 4 hours.
• ConferMED Coronavirus eConsults: Consult with experts to get answers to your clinical questions about COVID-19. This service is exclusively for primary care providers at safety net practices at no cost through ConferMED.
• ConferMED Specialty Care eConsults: With funding provided by the Quest Diagnostics Foundation, FQHCs in the Baltimore, Boston, Chicago, Houston and Miama metro area can access this service free of charge.
• MAVEN Project: MAVEN Project uses telehealth to connect primary care providers from safety net clinics with expert physician volunteers for consultations, mentoring, and education.  .