Federally Qualified Health Center
A Federally Qualified Health Center (FQHC) is a reimbursement designation from the
An FQHC is a community-based organization that provides comprehensive
Funded programs
Health programs funded include:[2]
- Community Health Centers which serve a variety of federally designated Medically Underserved Areas/Populations (MUA or MUP).
- Migrant Health Centers which provide culturally competent and primary preventive medical care to migrant and seasonal agricultural workers.[3]
- Health Care for the Homeless Programs which reach out to homeless individuals and families and provide primary and preventive care and substance abuse services[3] and
- Public Housing Primary Care Programs that serve residents of public housing and are located in or adjacent to the communities they serve.[3]
Leadership
FQHCs operate under a consumer Board of Directors governance structure and function under the supervision of the
Their mission has changed since their founding. Their mission now is to enhance primary care services in underserved urban and rural communities.
FQHCs provide their services to all persons regardless of ability to pay, and charge for services on a community board approved sliding-fee scale that is based on patients' family income and size. FQHCs must comply with Section 330 program requirements.[5]
In return for serving all patients regardless of ability to pay, the centers receive from the Federal government cash grant, cost-based reimbursement for their Medicaid patients, and malpractice coverage under the Federal Tort Claims Act (FTCA).[6]
Look-Alikes
The government also designates a category of health centers as "FQHC Look-Alikes." These health centers do not receive grants under Section 330 but are determined by the Secretary of the Department of Health and Human Services (HHS) to meet the requirements for receiving a grant based on the Health Resources and Services Administration recommendations.[4] Also, FQHC Look-Alikes receive cost-based reimbursement for their Medicaid services, but do not receive malpractice coverage under FTCA or a cash grant. Look-Alikes also qualify as health professional shortage areas (HPSA) automatically.
Services under Medicare
FQHC benefit under Medicare became effective October 1, 1991, when Section 1861(aa) of the Social Security Act was amended by Section 4161 of the Omnibus Budget Reconciliation Act of 1990.[4] FQHCs provide Medicare beneficiaries with preventive primary health services such as immunizations, visual acuity and hearing screenings, and prenatal and post-partum care.[4] However, eyeglasses, hearing aids, and preventive dental services are not covered under the FQHC preventive primary services. A FQHC Prospective Payment System (PPS) was scheduled to be implemented in 2014.[4] The Patient Protection and Affordable Care Act (ACA) mandates that the Centers for Medicare and Medicaid Services (CMS) collect and analyze health services data prior to developing and implementing the new payment system. This requires that the appropriate revenue code and Healthcare Common Procedure Coding System (HCPCS) code be listed with each service provided.[4] Currently,[when?] Medicare pays FQHC directly based on an all-inclusive per visit payment.[4]
Advanced Primary Care Practice demonstration project
In June 2011, the Department of Health and Human Services announced the Federally Qualified Health Center Advanced Primary Care Practice (FQHC APCP) demonstration project.
President Bush launched the Health Centers Initiative to significantly increase access to primary health care services in 1,200 communities through new or expanded health center sites. Between 2001 and 2006, the number of patients treated at health centers increased by over 4.7 million, representing a nearly 50 percent increase in just five years. In 2006 the number of patients served topped the 15 million mark for the first time.[citation needed]
Throughout the United States there are over 1,000 health centers that operate approximately 6,000 sites.[1] In 2010, the health centers served an estimated 20 million patients.[3] The data collected via the Uniform Data System (UDS) reports that of those patients served, 62 percent were members of a racial or ethnic minority (predominantly Hispanic), 93 percent lived at or below 200 percent of the federal poverty level, 72 percent lived at or below 100 percent of the federal poverty level, and 38 percent were uninsured.[9] In particular, during 2010 health centers served 862,775 migrant and seasonal farm workers and their families; more than 1 million individuals experiencing homelessness; and 172,731 residents of public housing.[3]
Impact of the Patient Protection and Affordable Care Act
The health center program's annual federal funding has grown from $1.16 billion in fiscal year 2001 to $1.99 billion in fiscal year 2007. The passage of the
Total centers by location
State or Territory | FQHCs |
---|---|
Alabama | 14 |
Alaska | 28 |
American Samoa | 1 |
Arizona | 21 |
Arkansas | 12 |
California | 176 |
Colorado | 20 |
Connecticut | 16 |
Delaware | 3 |
District of Columbia | 8 |
Fed. States of Micronesia | 3 |
Florida | 48 |
Georgia | 35 |
Guam | 1 |
Hawaii | 14 |
Idaho | 14 |
Illinois | 45 |
Indiana | 25 |
Iowa | 14 |
Kansas | 18 |
Kentucky | 23 |
Louisiana | 34 |
Maine | 18 |
Marshall Islands | 1 |
Maryland | 17 |
Massachusetts | 39 |
Michigan | 39 |
Minnesota | 16 |
Mississippi | 21 |
Missouri | 28 |
Montana | 17 |
Nebraska | 7 |
Nevada | 5 |
New Hampshire | 11 |
New Jersey | 23 |
New Mexico | 17 |
New York | 65 |
Northern Marianas | 1 |
North Carolina | 38 |
North Dakota | 4 |
Ohio | 45 |
Oklahoma | 20 |
Oregon | 31 |
Pennsylvania | 44 |
Puerto Rico | 20 |
Republic of Palau | 1 |
Rhode Island | 8 |
South Carolina | 22 |
South Dakota | 5 |
Tennessee | 29 |
Texas | 73 |
Utah | 13 |
Vermont | 11 |
Virgin Islands | 2 |
Virginia | 26 |
Washington | 27 |
West Virginia | 27 |
Wisconsin | 17 |
Wyoming | 6 |
Total | 1,367 |
References
- ^ a b Michelle M. Doty; Melinda K. Abrams; Susan E. Hernandez; Kristof Stremikis; Anne C. Beal (May 2010). "Enhancing the Capacity of Community Health Centers to Achieve High Performance". The Commonwealth Fund.
- ^ "About the Health Center Program". bphc.hrsa.gov. Retrieved 2018-03-28.
- ^ a b c d e "Special Populations". Department of Health and Human Services. Health Resources and Services Administration. Archived from the original on 12 January 2012.
- ^ a b c d e f g h i j k "Federally Qualified Health Center". Department of Health and Human Services. Centers for Medicare and Medicaid Services. November 2011.
- ^ a b "Health Center Program Compliance Manual" (PDF). bphc.hrsa.gov. 2017. Retrieved 2018-03-27.
- ^ "About the Federal Tort Claims Act (FTCA)". bphc.hrsa.gov. Retrieved 2018-03-28.
- ^ a b c "New Affordable Care Act support to improve care coordination for nearly 200,000 people with Medicare". Department of Health and Human Services. June 2011.
- ^ a b c d "Medicare Demonstrations: FQHC APCP FAQs". Centers for Medicare and Medicaid Services. Archived from the original on 2012-03-16. Retrieved 2012-02-01.
- ^ "Health Center Data". Department of Health and Human Services. Health Resources and Services Administration. Archived from the original on 2012-02-01. Retrieved 2012-02-01.
- ^ a b "Summary of New Health Reform Law". The Henry J. Kaiser Family Foundation. April 2011.
- ^ "Number of Federally-Funded Federally Qualified Health Centers, 2016". The Henry J. Kaiser Family Foundation.
External links
- Bureau of Primary Health Care
- Center for Medicare and Medicaid Advocacy
- National Association of Community Health Centers
- Maine Primary Care Association
- HealthReach Community Health Centers
- General information Texas Association of Community Health Centers
- Community Health Center Association of Connecticut
- Community Health Center of Central Florida