Partnering to Succeed: How Small Health Centers Can Improve Care and Thrive Under Value-Based Payment

Parterning to Succeed: How Small Health Centers Can Improve Care and Thrive Under Value-Based Payment
Publication date
Publisher

California Health Care Foundation

Contributors

MacColl Center for Health Care Innovation at Kaiser Permanente Washington Health Research Institute (Katie Coleman, Clarissa Hsu, Heidi Berthoud, Brian Austin, and Ed Wagner)

JSI Research & Training Institute, Inc. (Rachel Tobey, Kiely Houston, Jim Maxwell, and Sofia Rojasova) 

Carolyn Shepherd, Leibig Shepherd LLC 

Jeff Hummel, Qualis Health

In California, CHCs serve more than 4 million people annually. Many CHCs in California and nationally are experimenting with strategies to improve and expand care, such as finding ways to integrate behavioral health, bolster team-based care, and proactively reach out to patients with unmet preventive or chronic care needs. In tandem, health centers are increasingly participating in value-based payment. These actions require consider­able infrastructure, with many components necessary for both endeavors. All health centers struggle to put this infrastructure in place, but small health centers — defined for the purposes of this paper as having fewer than 10,000 patients or an annual budget of $10 million or less — face unique challenges in securing access to capital, building strong data capabilities, and negotiating favorable rates with vendors and contracts with health plans. 

To help clarify the way forward for small health centers, this paper presents a Model for Advancing High Performance (MAHP). Based on research and expert opinion, it describes the actions and infrastructure CHCs will need to thrive in this new environment and contribute to a sustainable primary care safety net that achieves the quintuple aim — better care, better health, lower costs, happier staff, and reduced health disparities.

The following case studies provide examples of seven types of partnerships for small health centers:

  • Hill Country Community Clinic (pg. 39)
  • Health Center Partners of Southern California (pg. 41)
  • Community Health Center Network (pg. 45)
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