The Legislature finds and declares all of the following:
- (a) Health care today is more than a face-to-face visit with a provider, but rather a whole-person approach, often including a physician, a care team of other health care providers, technology inside and outside of a health center, and wellness activities, including nutrition and exercise classes, all of which are designed to be more easily incorporated into a patient’s daily life.
- (b) Accessible health care in a manner that fits a patient’s needs is important for improving patient satisfaction, building trust, and ultimately improving health outcomes.
- (c) FQHCs are essential community providers, providing high-quality, cost-effective comprehensive primary care services to underserved communities.
- (d) Today, FQHCs face certain restrictions because the current payment structure reimburses an FQHC only when there is a traditional encounter with a provider. Current law prohibits payment for both a primary care visit and mental health visit on the same day.
- (e) A more practical approach financially incentivizes FQHCs to provide the right care at the right time. Restructuring the current visit-based, fee-for-service model with a capitated equivalent affords FQHCs the assurance of payment and the flexibility to deliver care in the most appropriate patient-centered manner.
- (f) A reformed payment methodology will enable FQHCs to take advantage of alternative encounters. Alternative encounters, such as group visits and email consultations, are effective care delivery methods and contribute to a patient’s overall health and well-being.
(g) An alternative payment methodology for FQHCs, designed and implemented as permitted by federal law, should do all of the following:
- (1) Provide patient-centered care delivery options to California’s expansive Medi-Cal population.
- (2) Promote cost efficiencies, and improve population health and patient satisfaction.
- (3) Improve the capacity of FQHCs to deliver high-quality care to a population growing in numbers and in complexity of needs.
- (4) Transition away from a payment system that rewards volume with a flexible alternative that recognizes the value added when Medi-Cal beneficiaries are able to more easily access the care they need and when providers are able to deliver care in the most appropriate manner to patients.
- (5) Promote timely, accurate, complete, and systemic reporting of alternative encounters at FQHCs.
- (6) Implement the APM where the FQHC receives at least the same amount of funding it would receive under the current payment system, and in a manner that does not disrupt patient care or threaten FQHC viability.