Building Bridges to Value: Infrastructure Essentials for Community Health Centers

Abstract

Primary care providers, especially those working within community health centers (CHCs), are pivotal in the shift from fee-for-service to value-based payment (VBP) for health care. VBP models, in turn, offer financial incentives like up-front care management payments or shared savings opportunities. However, successfully adopting VBP models demands new competencies and investments, a challenge made more acute for many CHCs, which face financial pressures as they strive to provide high-quality, accessible care to all. This report offers CHCs, their partners, policymakers, and others a place to start in addressing these challenges, particularly as the safety net faces potential cuts in federal funding for Medicaid. Drawing on interviews with experts and available literature, the authors organize the services and supports critical for VBP success into a practical framework consisting of four infrastructure domains: (1) leadership, governance, and legal; (2) operations; (3) data, analytics, and technology; and (4) financial. Each domain is explored in depth, with real-world examples and actionable recommendations to help CHCs prioritize investments tailored to their specific VBP opportunities. The report also offers considerations to help CHCs make informed, context-specific choices as they implement VBP models that optimize their resources and impact.