Medicines360 Announces Collaborative Research to Increase LARC Access in FQHCs

Federally Qualified Health Centers (FQHCs) are community-based providers that exist to meet patients where they live and provide the primary care services they need. With approximately 12,000 service delivery sites located across the country. FQHCs serve a large number of both insured and uninsured patients. FQHCs have sliding fee scales for uninsured patients to make care affordable and accessible.

As part of their mandate to provide primary care services, FQHCs deliver publicly funded family planning care to approximately 2 million women each year. However, these health centers can face unique challenges to offering long-acting reversible contraceptives (LARCs), meaning that not all FQHC patients have access to the full range of FDA-approved contraceptive methods.

Medicines360, with Waxman Strategies and Camber Collective, conducted research to identify these challenges through surveys and interviews with providers, administrators, and policy stakeholders between January 2019 and June 2019. Addressing these challenges would extend greater contraceptive choice to larger numbers of safety-net patients across the country.

In a white paper published this month, we provide the following recommendations:

  1. Provide targeted training and technical assistance. FQHCs should be given expanded access to clinical training and technical assistance on topics relating to family planning, including patient-centered counseling and services for LARC methods alongside the full range of FDA-approved contraceptive methods, consistent with national quality family planning (QFP) guidelines.
  2. Protect and expand grant programs and the use of evidence-based guidelines. On top of sustaining funding levels for Title X and Section 330, policymakers should consider safeguarding Title X’s evidence-based guidelines and clarify that FQHCs should provide affordable access to all 18 FDA-approved methods of contraception.
  3. Collect and report data on family planning care provided at FQHC sites. The federal government should collect, analyze, and report detailed data on the performance of FQHCs in the family planning context and measure their impact.
  4. Design optimal Medicaid reimbursement rates policies. Since Prospective Payment System (PPS) encounter rates are often too low to cover the cost of LARC-related care at FQHCs, policymakers should consider unbundling or “carving out” LARC product and service reimbursements from PPS rates.
  5. Reform state scope-of-practice and licensing laws. Although non-physician clinicians such as advanced practice registered nurses (APRNs) are trained in the provision of a range of services, various legal and reimbursement challenges may prevent them from helping to meet the need for family planning. State policymakers should consider removing barriers for non-physician clinicians.
  6. Enhance collaboration, training, and sharing of best practices. States should convene key family planning stakeholders into LARC learning collaboratives to establish referral systems, share resources, identify trainers, and share best practices on patient-centered counseling and services. These collaboratives should build on the insights of past efforts, such as the Increasing Access to Contraception Learning Community

To learn more about the research methodology, findings, policy recommendations, the full white paper is accessible here.

About Medicines360

Medicines360, located in San Francisco, California, is a nonprofit global women’s health pharmaceutical organization with a mission to catalyze equitable access to medicines and devices through product development, policy advocacy, and collaboration with global and US partners. Medicines360, through its subsidiary Impact RH360, launched the Avibela Project to expand access to hormonal IUDs in low- and middle-income countries. For more information, visit medicines360.org

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  77. Sudan
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  79. Tanzania
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  81. The Gambia
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  83. Togo
  84. Tunisia
  85. Uganda
  86. Vietnam
  87. Zambia
  88. Sri Lanka

Tina Raine-Bennett, MD, MPH, FACOG

Chief Executive Officer

Tina Raine-Bennett, MD, MPH, is CEO of Medicines360. Previously, she served as a senior research scientist at the Kaiser Permanente Northern California Division of Research and the research director of the Women’s Health Research Institute. She is a Board-Certified Obstetrician Gynecologist who received her medical training at the University of California, San Diego, and post-graduate residency training and MPH at the University of Washington in Seattle, where she also completed a Robert Wood Johnson Clinical Scholars Fellowship. She was also senior staff physician at Kaiser Permanente and has a special interest in family planning and adolescent reproductive health.

As the director of the Women’s Health Research Institute, Dr. Raine-Bennett focused on expanding research on women’s health within the Division and translating women’s health research into clinical practice and policy within the Ob/Gyn departments in Northern California. She also promoted the involvement of clinicians in research designed to improve the health outcomes and healthcare experiences of women at Kaiser Permanente and women in general.

Prior to Kaiser Permanente, Dr. Raine-Bennett was a professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at University of California, San Francisco (UCSF). She was based at San Francisco General Hospital where she was also the medical director of the New Generation Health Center, a UCSF affiliate site that provides community-based reproductive health services. Dr. Raine-Bennett’s research has focused on contraceptive methods and on elucidating factors that influence contraceptive choice and continuation, and she was principal investigator on NIH grants to assess hormonal contraceptive use predictors and develop interventions to improve contraceptive access.

Her past and current research on emergency contraception has focused on the safety of making emergency contraception more accessible and she conducted a pivotal clinical trial to make emergency contraception available to teens without a prescription. She served on the editorial board of Obstetrics and Gynecology and has over 100 peer-reviewed publications. She was the Treasurer of the Board of Directors for the Society of Family Planning and Society of Family Planning Research Fund. She has also served as an examiner for the American Board of Obstetrics and Gynecology, and on national committees for the American College of Obstetrics and Gynecology and the National Medical Board of Planned Parenthood Federation of America.