Stepping Up to the Plate: Federally Qualified Health Centers Address Growing Demand for Care

California's Federally Qualified Health Centers (FQHCs) are key primary care providers for low-income people and have been expanding their capacity due to several market and policy factors, particularly the implementation of the Affordable Care Act (ACA). FQHC expansion is happening both within individual organizations, through the creation of new organizations and sites of care, and through collaborations with other providers, driven by the main goals to serve more patients, improve integration and efficiency of care, and position these providers for a potential movement to value-based payments. These collaborative strategies involve not only extending primary care capacity but also improving access and integration for behavioral health, specialty care, and social services.

The California Health Care Foundation's longitudinal Regional Markets Study provided a unique opportunity to track FQHC capacity expansion, collaborative strategies over time, and variation across regions.

This paper focuses on collaborations among FQHCs, other safety-net providers and agencies, and some more mainstream providers (those that serve large populations of commercial and Medicare patients). It describes key examples highlighted by FQHCs and other safety-net providers, as well as market observers, from the seven regions, and discusses the motivations behind each strategy and the challenges they face.