The Role of Federally Qualified Health Centers in State-led Medical Home Collaboratives

The medical home is a model of care that is taking root in both public and private payer programs in an effort to improve quality, control costs and increase both patient and provider satisfaction. Since 2006, more than 30 states have been leading efforts to advance medical homes in their Medicaid and Children’s Health Insurance Program (CHIP). Several states are leading multi-payer medical home collaboratives to spread this model in the private sector.

States have used multi-payer collaboratives to convene disparate groups of purchasers, payers and providers to discuss health delivery system reform aimed at improving outcomes and lowering rising costs. Having the state as a neutral convener can allay both payers’ and providers’ fears that anti-trust issues will be raised by having a common effort.

Using telephone interviews with public and private stakeholders in Pennsylvania, Rhode Island and Vermont, this report describes each state’s multi-payer medical home collaboratives and the role that federally qualified health centers (FQHCs) play. We hope this report will be of value for other state policy makers looking to develop similar pilots, as well as describe opportunities for FQHCs, primary care associations and others who want to become engaged in state efforts to advance patient-centered medical homes.

The interviews and health policy briefing were supported through a National Cooperative Agreement (Number U30CS09747-01-00) with the federal Health Resources and Services Administration, Bureau of Primary Health Care (HRSA/BPHC). This briefing and other project activities are intended to help inform state policy making as it affects community health centers in order to promote achievement of shared goals of improved access to quality, affordable, health care for our nation’s most vulnerable populations.