Peter Shin

Addresses gaps in the evidence base in order to explore patients’ experiences using community health centers for their family planning and reproductive health care, examine factors that either hinder or facilitate receipt of family planning services, from the patient’s perspective, and make recommendations regarding how health centers can improve their family planning services.

Argues that 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. 

Argues that the HRSA’s quality improvement strategy should include the development of actionable performance measures, training and technical assistance, special supplemental grant awards to support quality improvement efforts and expansion of family planning services, and collaboration with CMS to identify purchasing strategies that can promote the goals of the guidelines, as translated and made actionable in a health center setting

Provides a current snapshot of health centers and discusses recent developments that can be expected to have a significant impact on health center growth in the coming years.

Examines how health centers fulfill their family planning mission.

Reports on the scope of services provided at Federally Qualified Health Centers (FQHCs) – a major and growing source of primary care for low-income women of reproductive age – including on-site provision, prescription-only and referral options for a range of contraceptive methods. Only limited knowledge exists on the scope of family planning care these centers provide and the mechanisms for delivery of these essential reproductive health services, including family planning.

Indicates that length and content of primary care visits are comparable for safety-net and other patients. The main factors that contribute to differences in visit length and content are patients’ health needs and the type of visit involved.

Compares the strength of health centers in states that have expanded Medicaid coverage for adults to health centers in states with more limited Medicaid coverage for adults in order to better understand how Medicaid influences health center practice. In sum, broader Medicaid eligibility for adults appears to be associated with an enhanced ability of health centers to invest in capacity-building activities to meet the needs of patients and communities.