FQHC Consortium Using FCC Award, Telehealth to Tackle the Digital Divide

A Massachusetts-based consortium of federally qualified health centers is using telehealth to address barriers to access caused by social determinants of health.

The FQHC Telehealth Consortium, a partnership of the Community Care Cooperative (C3) and the Massachusetts League of Community Health Centers, is launching a project focused an tackling the digital divide, which disproportionally affects underserved communities in the Bay State. The project has an initial budget of $4.7 million and is supported in part by a $3.1 million award from the Federal Communications Commission’s Connected Care Pilot Program.

“Most health centers are moving to a proactive digital health strategy,” Michael Curry, president and CEO of the Massachusetts League of Community Health Centers, the state’s primary care association, said in a press release. “Their leaders recognize telehealth’s ability to drive patient access and equity, and as a ‘new normal’ necessity in staff recruitment and retention. It is critical for FQHCs to remain competitive in an ever-changing healthcare landscape, and efforts to increase telehealth support must be carried out with a focus on sustainability and equity.”

The program is the second phase of a massive project aimed at equipping the consortium’s 35 health centers with the technology and training to launch and scale up connected health programs. The first phase cost $5 million, was launched in 2020 – at s the coronavirus pandemic was taking off – and took just six months to complete.

This time, they’re going after socioeconomic barriers that hinder or prevent underserved residents from access healthcare and health and wellness services.

Part of that strategy tackles broadband connectivity – a key component to the Connected Care Pilot Program and other efforts by the FCC to help healthcare providers extend telehealth platforms into rural and remote parts of the country. Telehealth won’t work well if it isn’t on a reliable broadband network, or if patients can’t access internet or afford to tools to connect with care providers.

FQHCs, Rural Health Centers (RHCs) and community health clinics offer unique opportunities to address those needs, because they often serve as the primary care providers – and sometimes the only point of contact - for underserved communities.

Federal support for access to and coverage of telehealth services had been limited for these sites, but those restraints have been lifted during the COVID-19 public health emergency, and pressure is building on Congress to continue that support beyond the pandemic.

“Nearly one in every six households in Massachusetts lacks broadband access, and with more healthcare taking place virtually, patients in under-resourced communities can find themselves ‘off the grid,’” C3 President and CEO Christina Severin said in the release. “It is absolutely essential that we close this digital divide. Telehealth is not only needed to fight COVID-19, it is proven effective in providing better, more convenient care for lower-income and BIPOC (black, indigenous and people of color) communities, and will be critically important when the pandemic is over.”

Phase 2 “will focus on ensuring that FQHCs have what they need to fully develop, deploy, sustain and integrate telehealth modalities into primary and behavioral care,” the press release states. “This includes providing better access to broadband, remote patient monitoring equipment, increased digital literacy training and outreach in communities that health centers serve.”

“In addition, the campaign’s policy and advocacy initiatives will focus on concretizing that lack of access to broadband and other technology as a social determinant of health that must be prioritized to avoid a deepening of existing racial health inequities,” it continues. “The campaign will work to focus policymakers on this emerging issue and champion solutions to meet this basic need for everyone who lives in the Commonwealth – and beyond.”

Through the first phase of the project, coalition officials say they were able to help 35 FQHCs in the consortium retain about 80 percent of revenues they’d been getting before the pandemic, while greatly expanding the number of virtual visits for behavioral health and dental issues. They also saw a 93 percent approval rate from patients for telehealth services.

“However, disparities in satisfaction by race and ethnicity in video visits and other areas indicate increased need for digital-literacy training, access to connected devices and efforts to improve broadband access, which Phase II of the campaign will work to address,” the release concluded.

Aside from the FCC grant, the project is also being funded through an anonymous donation of $1.04 million, $500,000 from the Commonwealth of Massachusetts and a $40,000 grant from the state’s Department of Public Health.