New C2C Resources
Check out the latest C2C resources helping consumers understand their coverage and the preventive services available. These resources also help partners and providers serve individuals in their community:- Telehealth: What to Know for Your Family – Learn about the types of care available through telehealth and how you and your family can use this technology for quality care. This resource was updated in September to include broader and more concise language.
- Telehealth for Providers: What You Need to Know – Discover useful information for health care providers about telehealth including how to get started, billing considerations for Medicare and Medicaid, when to use telehealth, and more. This resource was also revised in September to be more evergreen following the end of the COVID-19 PHE and conclusion of Medicaid Unwinding in most states.
- College Students Preventive Services Flyer and View Your Path to Better Student Health Poster now available in eight additional languages (Arabic, Chinese, Haitian Creole, Korean, Russian, Spanish, Ukrainian, Vietnamese) on the C2C site. Download the translations from the Get Preventive Care, Resources for Partners and Providers, and View All Resources webpages.
From December 2-6, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) marks National Influenza Vaccination Week by highlighting vaccine disparities and encouraging everyone to get their flu shot, which can reduce the risk of illness, hospitalization, and death.
The Centers for Disease Control and Prevention (CDC) estimates that flu was associated with up to 75 million illnesses, 33 million medical visits, 900,000 hospitalizations, and 100,000 deaths during the 2023-2024 flu season. While everyone 6 months and older should receive a flu shot each year, people with a higher risk of serious complications from the flu—including pregnant people and children—should especially ensure that their vaccines are up to date. Black, Hispanic, and American Indian and Alaska Native adults are consistently less likely to get a flu shot, with fewer than half receiving their flu shot in 2021-2022. Rural residents are also less likely to get their flu shot than people in urban areas.
Our Immunization and Vaccine Resources webpage has flu and vaccine information to help raise awareness this flu season. We encourage you to share these resources and the others listed below with those you serve during National Influenza Vaccination Week.
Resources
- Visit our Immunization and Vaccine Resources webpage to learn more about flu vaccines for underserved populations, including materials in additional languages.
- Review our Annual Influenza Vaccination Disparities in Medicare Beneficiaries data snapshot to learn about who should get the flu vaccine and about flu shot disparities among Medicare fee-for-service enrollees.
- Download CMS postcards available in English, Spanish, and 14 additional languages to encourage members of your community to get their flu shots.
- Review our Coverage to Care Prevention Resources to learn about the services, including vaccines, that are available at no cost to adults under most health coverage. Resources are available in 8 different languages.
- Download Rural-Urban Disparities in Health Care in Medicare to learn more about rural-urban differences in health care experiences and clinical care received nationally, including disparities in flu vaccine uptake.
- Explore the CMS flu webpage for information, videos, and resources about the flu.
- View the CMS Respiratory Virus Vaccine Partner Toolkit to stay informed about CMS, CDC, and HHS resources available regarding flu, COVID-19, and RSV.
- Visit the CDC’s Cold Versus Flu webpage for more information on differentiating between the flu and a cold.
- Visit Vaccines.gov to find vaccination locations.
- Explore the CDC’s Misconceptions About Seasonal Flu and Flu Vaccines webpage, which addresses common misconceptions about the flu and flu shot.
- Learn about the HHS Risk Less. Do More. campaign, which launched in August 2024 to inform the public about common respiratory viruses and available vaccines.
Access the Webinar Recording 2025 Final Rule: New Remote Care Models
[/vc_column_text][vc_column_text css=".vc_custom_1733158516613{padding-top: -30px !important;}"]The 2025 Medicare Physician Fee Schedule Final Rule provides additional compensation to FQHCs and RHCs providing care coordination services. Geared specifically towards Community Health Centers, this webinar covers the latest reimbursement opportunities, making remote care more accessible than ever. Our experts explain everything you need to know about the latest Remote Care Model. Learn how remote care reimbursements open doors for improved patient outcomes. Access the webinar, for info on:- FQHC PPS Market Basket
- New Remote Care Model
- Remote Patient Monitoring
- Remote Care Management
- Telehealth Reimbursement
- Payment for Preventative Services
Request a demo to learn how your center can benefit from RPM.
[/vc_column_text][wpforms id="3973" title="false" description="false"][/vc_column][/vc_row][/vc_section][vc_row][vc_column][vc_column_text] [/vc_column_text][/vc_column][/vc_row]The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) celebrates National Health Center Week (NHCW) from August 4-10. NHCW, sponsored by the National Association of Community Health Centers, honors the nearly 1,400 community health centers nationwide that provide health care services to 31 million+ patients across more than 15,000 communities each year. This year’s NHCW theme is “Powering Communities Through Caring Connections” and focuses on connecting communities with their local health centers to improve health outcomes.
Community health centers contribute significantly to addressing health disparities by providing quality care to all people despite their ability to pay. Specifically, they serve a disproportionate number of people with a low income and people from racial and ethnic minorities, including those living in rural areas and those with limited English proficiency. CMS OMH provides resources and support to CHCs to help them disseminate important health information to their patients. Through the Coverage to Care (C2C) initiative, CMS OMH connects CHCs and other providers to materials they can share with patients to help them understand their health coverage and the care options available to them. Share the resources below to help CHCs continue to provide quality care and reduce health disparities throughout NHCW and all year.
Resources
- Visit the C2C webpage to access our resources that can help providers and patients understand their health coverage and care options, such as the C2C Roadmap to Better Care, the Manage Your Chronic Condition webpage, and C2C’s prevention resources.
- Watch our C2C Community Connections Tour video to learn how the initiative meets communities where they are at, bringing resources directly to those who need them.
- Visit our Rural Health Resources webpage to access CMS and other HHS resources like the Rural Health Clinics Center and the Federally Qualified Health Centers Center that can help you provide care to rural communities.
- Review the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities, which outlines how CMS is working to promote access to equitable care in rural, Tribal, and geographically isolated communities.
- Use the Mapping Medicare Disparities Tool to identify disparities between subgroups of Medicare enrollees within the communities you serve in areas like health outcomes, utilization, and spending.
- View the Health Resources & Services Administration’s (HRSA) Bureau of Primary Healthcare website to learn how your organization can become a funded health center.
- Find a health center near you using HRSA’s tool.
- Visit the National Health Center Week website to find NHCW events near you and explore related resources and activities.
Vaccines help protect people of all ages against many diseases and conditions. In August, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is working to increase access to vaccines and encouraging those served by CMS to get their routine shots in honor of National Immunization Awareness Month. The Centers for Disease Control and Prevention (CDC) advises that everyone aged 6 months and older receive updated COVID-19 vaccines and flu shots each year. The CDC also recommends other routine vaccinations based on age.
However, fewer than 1 in 4 adults aged 19 or older received all their recommended vaccines in 2019. Minority populations have even lower vaccination rates, with only 15.9% of Black adults and 17.3% of Hispanic adults receiving routine vaccines compared to 23.7% White adults. Black (39.0%) and Hispanic (37.5%) Americans, as well as people who identify as other or multiple race (41.4%), also have lower flu vaccination coverage when compared with White (49.3%) adults. Significant disparities in access and health coverage, as well as a history of discrimination and distrust, contribute to these racial inequities in vaccination.
Disparities also exist in vaccination rates among children. In 2019, only 48.9% of Black children and 60.6% of Hispanic children between the ages of 6 months and 4 years old received their flu shot, compared to 64.1% of White children. Additionally, fewer children in rural areas received flu vaccines (51.8%) than those in urban areas (64.7%). The CMS Connecting Kids to Coverage National Campaign encourages families to enroll their children in health coverage so they can get the care and vaccines they need, especially as they go back to school.
During National Immunization Awareness Month, you can help your communities get vaccinated and stay healthy. Review and share the resources below to help those you serve learn more about recommended vaccines and how to access them.
Resources
- Immunization and Vaccine Resources
- Coverage to Care Prevention Resources
- Annual Influenza Vaccination Disparities in Medicare Beneficiaries
- Flu Vaccine Partner Toolkit
- Adult Vaccine Assessment Tool
- Vaccine Information for Adults
- Vaccines for Your Children
- Adult Immunization Schedule
- Child & Adolescent Immunization Schedule
- CDC "Back-to-School" Campaign
- Connecting Kids to Coverage
- Resources to Encourage Routine Childhood Vaccinations
- Vaccines for COVID-19
[vc_row full_width=""][vc_column][vc_column_text]July 10 2024 - Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), proposed new policies in the calendar year (CY) 2025 Medicare Physician Fee Schedule (PFS). Proposed policies would increase value-based care, strengthen primary care, and expand access to behavioral and oral healthcare.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][ut_btn button_align="bklyn-btn-left" font_weight="bold" button_text="View CMS Fact Sheet" button_text_color="#ffffff"][/vc_column][/vc_row][vc_row][vc_column][ut_title_divider_2 line_height="1"][/ut_title_divider_2][vc_column_text css=".vc_custom_1721151102929{padding-bottom: -75px !important;}"]Get ahead of these changes. The experts at Vigilance Health turn obstacles into opportunities.
[/vc_column_text][wpforms id="3910" title="true" description="true"][/vc_column][/vc_row]Advancing health equity during Pride Month
The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) celebrates Pride Month each June by highlighting the unique health care challenges and barriers faced by members of the Lesbian, Gay, Bisexual, Transgender, Queer and Questioning, Intersex, Asexual, and Two Spirit (LGBTQI+) community and sharing resources to help promote equity.
Many LGBTQI+ individuals may have shared experiences when it comes to facing stigmas surrounding their sexual orientation or gender identity, but individual health outcomes often vary by race, ethnicity, income, and other characteristics. For example, transgender women experience a higher risk of HIV, with rates highest among Black transgender women (44%) and Hispanic transgender women (26%). Gay, bisexual, and other men who have sex with men are also disproportionately affected by HIV, making up 67% of all new diagnoses in the US.
Social determinants of health (SDOH) also contribute to poorer health outcomes among the LGBTQI+ community, including exposure to stressors like stigma, discrimination, violence, and anti-LGBTQI+ policies. For example, the poverty rate is higher among LGBTQI+ individuals (21.6%), specifically among transgender people and bisexual women (29.4%). SDOH factors can also contribute to mental health disparities, including depression, anxiety disorders, and health risk behaviors.
In addition to disparities in health outcomes, LGBTQI+ individuals continue to face barriers to accessing care, including an increased likelihood of being uninsured, delaying care, and being more concerned about medical bills than non-LGBTQI+ individuals. Many LGBTQI+ individuals are reluctant to disclose their sexual orientation to health care providers because they fear rude and discriminatory reactions or are concerned that their personal information could become public.
State and national surveys often lack questions on sexual orientation and gender identity (SOGI), creating a lack of information and gap in addressing disparities. To minimize this gap, CMS has updated the Health Insurance Marketplace application with new SOGI questions that will allow patients to reflect and affirm their identities. These questions will be used to help analyze health disparities in access to coverage. Additionally, we have recently updated the Caring for LGBTQI+ Patients Medicare Learning Network Training.
During Pride Month, CMS OMH is highlighting how you can help address these barriers and disparities impacting the LGBTQI+ community. Share these resources during Pride Month and beyond to help individuals receive better health care coverage.
Resources
- Recognizing Health Disparities in the LGBTQI+ Community
- Caring for LGBTQI+ Patients Medicare Learning Network Training
- HIV/AIDS Disparities in Medicare Fee-For-Service Beneficiaries
- LGBTQI+ Partners webpage
- Manage Your Chronic Condition webpage
- Coverage to Care (C2C) Enrollment Toolkit
- C2C Adult Preventive Services Flyer
- C2C Roadmap to Behavioral Health
- Health Insurance Coverage and Access to Care for LGBTQ+ Individuals: Recent Trends and Key Challenges
- Telehealth for LGBTQ+ Patients
- Center of Excellence on LGBTQ+ Behavioral Health Equity
- Protecting the Rights of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) People
- Lesbian, Gay, Bisexual, and Transgender Health Workgroup
- Healthy People 2030
FQHC Guide to HCPCS Code G0511 Expansion
[/vc_column_text][vc_column_text css=".vc_custom_1717007389643{padding-top: -30px !important;}"]Under the 2024 CMS Final Rule, FQHCs can now bill under code G0511 multiple times in a calendar month if the requirements for the underlying services are met. What do these changes entail, and how will health centers be affected? Download this guide for a look at:- Covered Programs
- Monthly Patient Engagement Examples
- CPT Codes & Payment Rates
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Two things we learned about Marc Hackett in our time together: he's a NASCAR fan, and this would be his first official interview. His love of racing certainly makes sense as Marc hails from and lives in Indiana, home of the legendary Indy 500 and Indianapolis Motor Speedway. More surprising was that he was new to interviews. He was so easy to talk to and shared so many valuable insights from his 28 years of experience in the Community Health Center (CHC) world and now as the CEO of Jane Pauley Community Health Center. In our interview, Marc tells us about his wins, challenges, and takeaways from implementing FQHC quality programs inside and beyond the center's walls. We also dive into hot topics like chronic care management (CCM), the power of Health Care Navigators (HCNs), and the importance of working within the Medicare 65+ population. We’d say that’s pretty impressive for a first interview. For some background, Marc joined Jane Pauley Community Health Center (JPCHC) as CEO in 2009. The newly founded organization had one site, serving 4,000 patients a year. Today, they are a recognized Federally Qualified Health Center (FQHC) and Patient-Centered Medical Home (PCMH) with ten sites and over 100,000 annual patient visits. It’s been a time of impressive growth but also rapid change, with a focus on partnerships with state hospital networks and health systems like the Indianapolis-based Community Health Network. During this time of expansion, Jane Pauley’s leadership team never wavered in their commitment to providing high-quality patient care. They kept care management and quality improvement strategies in mind and constantly looked for ways to improve patient experience and outcomes. Even when faced with shortages of staff, funding, and resources, they continued to find innovative ways to improve the quality of care they delivered. Hi, Marc! So nice to have you. Let’s start with a little background on Jane Pauley Community Health Center, that’s a pretty famous name.
Jane Pauley, or JP, as we call it, is central Indiana’s trusted nonprofit provider of affordable primary, behavioral, and dental health services. We’re an FQHC with 10 locations and over 250 staff, providing high-quality care regardless of coverage or ability to pay. Our patient population is about 65 percent Medicaid, 5 percent Medicare, 10 percent uninsured, and 20 percent privately insured. Our name, of course, comes from Emmy-winning TV news personality Jane Pauley. She’s done so many things: The Today Show, Dateline, and now she hosts CBS Sunday Morning. She was born in Indianapolis, Indiana, a fifth-generation Hoosier, and graduated from Indiana University. She also went to Warren Central High School, just a short walk from our offices. Jane Pauley lends us her name to care for her hometown. As a longtime children’s and mental health spokesperson, she’s been vocal in sharing her journey with late-diagnosed bipolar. She’s done a lot to remove stigmas around mental health, taking medications, and getting the care you need. She’s an exceptional person in our state and for our center.There’s been some pretty impressive growth at Jane Pauley. How do you manage that while keeping an eye on quality?
Patient experience and quality of care are part of everything we do. We are always looking for ways to close Gaps in Care (GIC) to improve our care management programs and, ultimately, our quality outcomes. Whether on a staff level or a new technology for EHRs, we want to constantly beef up our internal quality measures. One resource that we could not do without is our amazing Community Resource Navigators (CRNs). Huge shout out to our team!! They are the direct ties to our community and make a huge difference every day. Anyone can make an appointment with a CRN at our center, whether they are patients or not. The HCN helps with access to coverage, care, and other resources. They help sign people up for Medicaid on the spot and help them set up payment plans or apply the sliding fee scale. We’re fortunate to have certified State Health Insurance Assistance Program (SHIP) navigators on our team. They are versed in Medicare and can help with access to state coverage or even dual eligibility.What’s a unique way you’re working to improve outcomes?
Well, here in Indiana, we have an abundance of county fairs. I love a good fair, and being at the booth is always a great time. Fair food is fun, but this is a great chance to educate the community about nutrition or other health resources. However, our primary goal is to get people to schedule an HCN appointment. Let them know we are here, care is available, and we can help them with that process at no cost. When I’m at one of these community outreach events, I always make it a point to speak with any of our patients. I want to know about their experiences with us, both positive and negative. It’s a great way to get to the heart of the issue and see what needs to be fixed. As we know from our board of directors, community members, especially patients, offer the most significant insights.We love to share FQHC wins. Tell us about a care management achievement you are proud of.
While not specific to Indiana, we do struggle with tobacco use, consistently ranking in the country’s top 10. It’s a top priority and a big thorn in the side of every healthcare executive in the state. I’m specifically proud of a hypertension grant that Jane Pauley received. We worked to enroll over 1,100 patients in a hypertension/ high blood pressure improvement program, including free self-monitoring kits. The data collected flowed directly into our Epic EHR system. The program was very successful, with participants showing improved numbers and better overall control of their conditions.Talk to us about adding Chronic Care Management to your strategy.
Like many community health centers, JPHC is navigating our way through Chronic Care Management (CCM): non-face-to-face care coordination services for Medicare’s sickest beneficiaries—those with two or more chronic conditions. It’s a small percentage of our population, maybe 5%, so it can sometimes, I admit, fall to the side. Most health centers are structured that way. I’m honestly not sure why, and with the massive baby boomer generation growing older, we knew we needed to change that. Two things brought CCM to the forefront for me. The first was hearing a 65+ Medicare patient with multiple chronic conditions say, “You are the best-kept secret in town.” While it was a great compliment, we don’t want to be a secret. We want to be a resource and point of access for everyone in our community regardless of their coverage, Medicare, Medicaid, no coverage, private insurers. Especially with the exploding numbers of the 65+ population and their often more complex needs, we want people to know we are here and ready to serve them. The second thing was meeting up with Vigilance at the NACHC CHI Conference in Orlando. They had prepared a Population Health Strategy Report for us, showing how they could help us with that 65+ population. It really enticed me because what they’re offering is something we’d like to do ourselves, but we don’t have the staff, time, or resources to do population health for that Medicare population. Vigilance takes that extra step for us, conversing with patients and saying, " Hey, I noticed you didn’t get your flu shot; why not? Can I schedule your appointment for that? Or I see you were in the office last week, and the provider gave you instructions. Are you following them? If not, let's discuss why you’re not and see if we can rectify that. The model intrigued me, and when I brought this proposal back to our team, the leadership all agreed it was a worthwhile endeavor.Why are Chronic Care Management and similar programs becoming so important?
The 65+ age group is growing, that’s first and foremost. It just makes good sense to be prepared for demographic changes in your community. As people age, they may use the health system more, or maybe they should be but aren’t. They may require a bit more time with an advocate or help navigating complex care directives. We want people to know they can bring in all that overwhelming Medicare paperwork. Just gather it all up, stuff it in a bag, and bring it in. Our team will help you navigate the process and understand your choices for free, whether you are a patient or not. It’s a valuable resource, and we want people to know we're here. Many people also don’t realize that Medicare waives the $200 deductible for patients who go to FQHCs. Eliminating that fee removes one more obstacle to care. When Vigilance helps patients with this type of education, that helps us improve adherence and, ultimately, quality of care.What is the biggest hurdle for an FQHC looking to implement a Chronic Care Management program?
The only thing holding you back is you! The good news is there aren’t many upfront costs involved; eventually, you can bill for these services, creating downstream revenue. Again, this is what caught my eye with Vigilance. It’s kind of like “found revenue” that you didn’t have before.OK, that sounds very appealing. So what will you do with all this ‘Found Revenue’?
We’re big into education. We partner with a large family practice residency program through the Community Health Network. They have 30 residents. It’s a 10/10/10 model, so they graduate ten each year and bring in ten new each year. The residents rotate through one of our sites for their pediatric and OBGYN experience. FQHCs serve the neediest of the needy, and it’s an essential training experience for these providers. We hope to partner with them even more as we continue to grow. Another goal is to start a family nurse practitioner program. I think these programs would benefit any community health center. There’s a provider shortage, and we must consider new ways to handle the unique, growing, and complex needs of FQHC patients and other vulnerable populations. The provider shortage is especially prevalent in behavioral health, one of our fastest-growing service lines, and near and dear to the Jane Pauley mission. Coming out of COVID, we find that 70% of patients who come in for a primary care visit also deal with at least one behavioral health issue. There’s such a need for that type of care. We’ve hired over 40 behavioral health clinicians and could use 40 more. That’s another critical model we’re focusing on.Do you have any community events scheduled for the New Year? We’d love to share!
We’ll be back on the County Fair circuit for sure. But over the winter months, we'll definitely increase our community outreach around flu and other vaccinations. We can also help connect people to important resources like shelters and heating assistance.Marc, it’s been a pleasure speaking with you. Thank you for sharing your experiences. There are so many valuable takeaways for other FQHC leaders considering care management strategies. Again, it's hard to believe it was your first interview; you did an excellent job. Do you have any last thoughts you’d like to offer?
Providing the best possible care is the core of the FQHC mission. Everything we do should orbit around that goal. It’s never easy, and it’s ok to consider outside help. Do whatever it takes to make it happen. As we like to say at Jane Pauley, “If we see 400 patients today, that’s 400 chances to change somebody’s life. Let’s make sure it’s in a positive way.”[/vc_column_text][/vc_column][/vc_row][vc_row full_width=""][vc_column width="1/2"][vc_column_text]Interested in Care Management?
Request a Population Health Strategy Report to see the potential impact on your center. This complimentary assessment uses your organization's clinical data to calculate projected outcomes in quality measures and revenue.[/vc_column_text][ut_fancy_image image="3781"][/ut_fancy_image][/vc_column][vc_column width="1/2"][wpforms id="3881" title="false" description="false"][/vc_column][/vc_row]The new rule brings big changes and huge opportunities for FQHCs. Change is inevitable, but savvy execs see the potential.
[/vc_column_text][vc_column_text]Schedule a complimentary strategy session to learn how these updates can improve outcomes and increase revenue at your health center.- Understand 2024 Rule implications & opportunities.
- Review new remote care management services.
- Capitalize on multiple service lines in the same month.
