Document Type


Publication Date

Spring 2017


This paper will examine the question: What is the role of Federally Qualified Health Centers in delivering health care services to Medi-Cal beneficiaries, and what challenges can be addressed with healthcare policies, programs, and waivers? Detailed background research is given on Federally Qualified Health Centers and their ability to expand with the implementation of the Affordable Care Act, as well as information about provider shortage and other challenges in accessing care that the Medi-Cal population faces. Interviews with executive staff at two FQHCs in Los Angeles serve to explain specific policies, programs, and practices that allow local FQHCs to effectively serve their populations.

The interviews and background research combined with supplemental charts and figures illustrate key findings about the role of FQHCs. FQHCs have largely been able to expand in recent years with the implementation of the ACA, and have more funding resources available to them which has allowed them to expand both their patient population and their workforce. However, many of these centers also face provider shortage and lack sufficient incentives to prevent high provider turn-over. There are current opportunities such as the Medi-Cal 2020 waiver and the Wrap Cap Pilot that aim to instigate payment reform, expand services for the FQHC patient population, and improve healthcare delivery.

Despite challenges that they face, it is largely agreed that FQHCs hold an extremely important role in serving those on government-funded insurance, and that they are a cost-effective way of delivering care. Recommendations include guidelines for federal healthcare legislation, such as suggestions to maintain provisions seen in the Affordable Care Act about an insurance mandate, insurance subsidies, and Medicaid expansion. It is also recommended that FQHCs take advantage of local programs that offer loan repayment to providers in exchange for a commitment to serve in areas with provider shortage, and recommended that FQHCs engage in community outreach to spread awareness of these programs and recruit within the community.