BOSTON—The Baker-Polito Administration announced today it is making significant investments in the future of Federally Qualified Community Health Centers (FQHCs) through substantial rate increases in Medicaid (MassHealth) payments. These investments increase reimbursements for primary care, behavioral health, and dental services, in line with the Administration’s commitment to invest in preventive care and behavioral health treatment. Increasing behavioral health care in primary care is a core component of the Administration’s Roadmap for Behavioral Health Reform.
Nearly 50% of patients served at FQHCs are MassHealth members, and FQHCs provide more than 20% of MassHealth members’ primary care. These MassHealth rate increases will result in over $100 million of new funding for 33 FQHCs in 2022 and up to $600 million in new funding over the next 5 years. These dollars provide a strong financial foundation for the future.
These rate investments represent an increase of approximately 50% overall for FQHCs, including a minimum increase of 33% by health center for medical and psychiatry visits; a 65% rate increase for dental services; and doubling rates for behavioral health visits. FQHCs also will be reimbursed for previously non-billable services to support behavioral health integration, such as collateral time consulting among primary care and behavioral health teams within the FQHC to strengthen care coordination for their patients. On average, FQHCs will experience a $3.6 million increase in payments from MassHealth on an annual basis. Going forward, payment for these services will grow year-over-year to account for inflation and service changes.
Additionally, the Executive Office of Health and Human Services (EOHHS) through the Department of Public Health is announcing $3.1 M in new funding to support Community Health Centers’ ongoing efforts to increase vaccine acceptance and access among residents who have been disproportionately impacted by COVID-19. These funds will be used to expand the existing Community Health Worker (CHW) Ambassador Program to increase vaccine acceptance in historically marginalized communities. This latest award supports vaccine efforts, including in the 20 communities hardest hit by the pandemic through the Commonwealth’s Vaccine Equity Initiative. With this funding, CHCs have received $13.2 million for vaccine specific initiatives from the Commonwealth to date.
“Community Health Centers are essential partners of our MassHealth program, providing a robust range of community-based health care and serving as a as a trusted source of medical care for vulnerable communities across the Commonwealth. During the COVID-19 pandemic, CHCs have played a vital role in ensuring access to health care services – including COVID testing, treatment and vaccination – in some our most disproportionately impacted communities. These investments will ensure stability for FQHCs now and for the future as well as integration of behavioral health and primary care,” said Secretary of Health and Human Services Marylou Sudders.
“The magnitude of these investments is a game-changer for health centers and the patients they serve,” said Michael Curry, President and CEO of the Massachusetts League of Community Health Centers. “The implementation of a new payment methodology and resulting historic rate increases reflect a powerful commitment to primary care that will help us meet the depths of demand for medical, behavioral health and dental services in our high-need communities, and truly begin to move the needle on health equity across Massachusetts.”
“Approximately 46% of Community Health Center patients are MassHealth members, making CHCs an important partner in our efforts to move towards a more value-based delivery system that incentivizes quality, care coordination, and member experience. Investments in CHCs continue to be a key strategy towards meeting these goals and further addressing health equity in Massachusetts,” said Assistant Secretary for MassHealth and Medicaid Director Dan Tsai.
Rate increases will go into effect January 1, 2022. In the summer of 2021, MassHealth will provide FQHCs with $45 million in supplemental funding as a bridge until the new rate structure is in place. These increases build upon MassHealth’s 5-year, $190 million investment in CHCs and over $50M million in COVID-19 stabilization funding in addition to other federal and state support.
Eligible Federally Qualified Community Health Centers:
- Boston Health Care for Homeless
- Brockton Neighborhood Health Center Inc
- Caring Health Center
- Charles River Community Health
- Community Health Center of Cape Cod
- Community Health Center of Franklin County
- Community Health Connections Family Health Center
- Community Health Programs
- Dimock Community Health Center
- Duffy Health Center
- Edward M Kennedy Community Health Center
- Family Health Center of Worcester
- Fenway Community Health Center
- Greater Lawrence Family Health Center
- Greater New Bedford Community Health Center
- Harbor Health Services, Inc
- Harvard Street Neighborhood Health Center
- Healthfirst Family Care Center Inc
- Hilltown Community Health Centers, Inc
- Holyoke Health Center
- Island Health Care
- Lowell Community Health Center
- Lynn Community Health Center
- Manet Community Health Center
- Mattapan Community Health Center
- North End Waterfront Health
- North Shore Comm Health Center
- Outer Cape Health Services Inc
- South Cove Community Health Center
- Springfield Health Services for The Homeless
- Stanley Street Treatment and Resources (SSTAR)
- Uphams Corner Health Center
- Whittier Street Health Center
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