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 (NACHC) 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:
- The Digital Divide - access, broadband, equity
- Implementation & Operations - workflows, procedures, platforms
- Quality Assurance - measurement, data collection, improvement
- Data & Reporting - definitions, taxonomy, EHR alignment, reporting, systems/process
- Policy, Financial Reimbursement & Legal - advocacy efforts, regulatory surveillance
- Patient Engagement - patient education, navigation, outreach, technical support
- Clinical Delivery - clinician-focused services, CME/CEU, clinical skills, competencies
- 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!
In addition, NACHC and the Center for Connected Health Policy (CCHP) partnered to create this 2024 resource: E-Consult Trends Across Medicaid Programs and Impact on FQHCs
Telehealth Policy, Financial Reimbursement and Legal Resources for FQHCs:
- CMS Resources:
- CMS Medicare Learning Network Resources:
- HRSA Resources:
- HRSA Program Assistance Letter: Telehealth and Health Center Scope of Project (PAL 2020-01) - Updated April 15, 2020: 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.
- 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: This collection of case studies highlights ten community health centers’ promising practices and lessons learned in adoption or expansion of telehealth delivery in response to the covid-19 pandemic..
- Telehealth Optimization Quick Guide for Health Centers: Intended to support health centers looking to advance telehealth or virtual services as pandemic response and recovery progresses.
- Strategic Investments in Telehealth and Digital Tools for Health Centers: Maintaining Your Competitive Advantage Beyond the Pandemic: This short guide describes FQHC telehealth utilization and barriers to adoption pre and during COVID19 pandemic.
- Telehealth Taxonomy for FQHC Data Capture: The “minimum data set” that each individual FQHC should be able to capture with confidence within their data systems. These core data elements were selected within the context of: 1) potential for impact on quality metrics and reporting as well as 2) potential for impact on FQHC telehealth reimbursement policies.
- Telehealth and Virtual Services: A Guide for FQHCs and RHCs: During the COVID-19 pandemic, there was an urgent need to provide remote services to continue uninterrupted health care services to expand access and keep people safe. This resulted in a rapid increase in the delivery of telehealth services in the primary care setting. This guide provides helpful advice, checklists, resources, and best practices to optimize and support telehealth for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs)..
- Recorded content from the three session FQHC Webinar Series:
- 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 Virtual 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: Safety Net Connect offers primary care physicians access to a dedicated eConsult platform providing electronic specialist triage and advice, often in less than 4 hours.
- MAVEN Project: MAVEN Project uses telehealth to connect primary care providers from safety net clinics with expert physician volunteers for consultations, mentoring, and education.
- PicassoMD: Provides instant access to specialists via a secure technology platform for curbside chat consults with specialists.
