The California Federally Qualified Health Center Alternative Payment Model (FQHC APM) is a proposed initiative of the California Department of Health Care Services (DHCS). The FQHC APM is designed to move away from the traditional fee-for-service (FFS) payment system, which rewards the volume of services provided, to a model that rewards high-quality and cost-effective care that is coordinated, team-based, convenient to access, and best meets patient needs.

This guide is for leaders and staff in FQHCs that are considering or have committed to participating in the California FQHC APM. The guide includes practical resources for reimagining and redesigning how an FQHC delivers care so it can be successful in the FQHC APM. The guide will help FQHC leaders and staff:

• Understand the impact of participating in FQHC APM for your FQHC’s leaders, staff, and patients
• Identify key focus areas
• Set priorities
• Determine staffing needs
• Build and expand staff competencies

The guide is designed for all FQHC staff, including:

• Leadership. Chief executive officers, chief administrative officers, chief operations officers, chief financial officers, chief information officers, chief medical officers, chief behavioral health officers, chief strategy officers
• Providers. Physicians, physician assistants, nurse practitioners, certified nurse-midwives, therapists
• Licensed and unlicensed clinical staff. Nurses, social workers, medical assistants, counselors, pharmacists, care managers, care coordinators
• Operations. Administrative, information technology, and data analytics staff

Note: At the date of publication, the program is subject to approval by the Centers for Medicare & Medicaid Services at the US Department of Health and Humans Services. Information about the program contained in this guide reflects the most recently available details from DHCS and is subject to change. Official program guidelines are forthcoming from DHCS, and this guide will be updated as new information becomes available.

About the Authors

Greg Howe is a senior fellow; Karla Silverman, MS, RN, CNM, is associate director of complex care delivery; and Rob Houston, MBA, MPP, is director of payment reform at the Center for Health Care Strategies. CHCS is a policy design and implementation partner devoted to improving outcomes for people enrolled in Medicaid. CHCS works across sectors and disciplines to connect people and ideas to spark insights, build expertise, strengthen leadership, and spread innovations.