Geiger Gibson / RCHN Community Health Foundation Research Collaborative, issuing body.
Geiger Gibson Program in Community Health Policy, issuing body.
George Washington University, issuing body.
Jacobs Institute of Women's Health, issuing body.
Milken Institute School of Public Health. Department of Health Policy and Management, issuing body.
[Washington, D.C.] : Milken Institute School of Public Health, George Washington University, January 7, 2015
Community health centers represent an exceptionally important source of care for low-income women of childbearing age (age 15-44). In 2013, the nation's 1,200 health centers, operating in more than 9,100 urban and rural sites, furnished primary health care to one in five low-income women of childbearing age. Family planning is a required service at all community health centers. A 2013 study found that although virtually all health centers provide basic family planning services, health centers also show considerable variation in the scope and quality of those services. The receipt of Title X Family Planning funding is associated with expanded on-site services and stronger performance, a reflection of the fact that Title X provides additional resources tied to specific performance expectations. These twin characteristics of Title X funding in turn both encourage and enable health centers to strengthen their family planning services. The Federally Qualified Health Center (FQHC) Medicaid payment methodology, which has allowed health centers to extend their reach into medically underserved communities, provides general support for health center activities. The payment principles embodied in the FQHC payment approach could be used more effectively to achieve the same goal of improved performance in the area of family planning services, including efforts to improve on-site availability of long-acting reversible contraceptives (LARCs). Consistent with current thinking about how to use payment to incentivize performance, an FQHC payment approach that rewards high performance in the areas of clinical, counseling, and patient support aspects of family planning services could help bring about important improvements in the quality of on-site family planning services at health centers. Coupling tools such as CMS's Innovation Accelerator Program with up-front investments from the Health Resources and Services Administration (HRSA), state Medicaid agencies and health centers are ideally positioned to work together to improve the scope and quality of family planning services for health center patients at all points along the health care continuum, beginning with preconception care and continuing throughout the childbearing cycle.
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