What is a Federally Qualified Health Center and who do they serve?
Federally Qualified Health Centers (FQHC) began as Neighborhood Health Centers in 1965. Championed by President Johnson under the Office of Economic Opportunity, FQHCs quickly expanded from two clinics in 1967 into the nation’s largest primary care network today.
Federally Qualified Health Centers operate strictly on outpatient, primary care basis. Services offered include behavioral health, substance use disorder treatment and medication assisted treatment, telehealth, chronic disease management, preventative care, women’s health and OB-GYN services, podiatry, immunizations, radiology, laboratory, transportation and medication assistance, translation, case management and dental services. It is important to note that not every agency has all of the services listed. A patient should speak with their local clinic to determine what services are available in their area.
For over 50 years, Community Health Centers have provided high-quality, affordable, comprehensive primary and preventive health care in our nation’s underserved communities, delivering value to, and having a significant impact on America’s health care system. Health Centers are the health care home for 30 million Americans in over 14,000 communities across the nation. One in every twelve people in the United States gets their care in a community health center. Health Centers are a critical element of the health system, serving both rural and urban populations, and often providing the only accessible and dependable source of primary care in their communities. Nationwide, Health Centers serve one in every six residents of rural areas.
Benefit to local Communities and Economies
Federally Qualified Health Centers save America’s healthcare system 24 billion dollars a year due to their low cost of treatment for prevalent illnesses such as depression, asthma, diabetes and hypertension. In fact, FQHC’s serve a high number of patients with chronic illness. This trend may be due to the fact that people without health insurance tend to go longer before seeking treatment. When FQHC’s are built in their communities, the expanded access provides a gateway to long-forlorn treatment for America’s most vulnerable populations.
Another explanation for improved health outcomes in Federally Qualified Health Centers may be their dedication to social determinates of health. Low income communities often lack stable access to housing, safe neighborhoods, employment, transportation, food, utilities and medication. Federally Qualified Health Centers are in a unique position to combine care coordination and case management with traditional medical care, ensuring that the comprehensive needs of the patient are met in order to improve health outcomes and maintain healthy lifestyles.
What defines a FQHC?
Federally qualified health centers were designed to promote community engagement and sustainability, improve access to quality healthcare and alleviate the financial burden of healthcare on low-income communities. In order to become a Federally Qualified Health Center, a health organization must possess seven mandatory criteria. These seven criteria include:
- The organization must offer services regardless of a patient’s ability to pay,
- The agency is governed through a board comprised of patients,
- The agency must service a medically underserved or impoverished area,
- The focus of care must be comprehensive primary care,
- The agency is a nonprofit or public organization,
- The agency utilizes a sliding fee program for any patient in need and
- The FQHC is held accountable through a quality assurance program.
How are Federally Qualified Health Centers funded?
In the beginning, Federally Qualified Health Centers did not use state funding and relied on federal funding deposited directly to local nonprofits. However, as the need for Federally Qualified Health Centers grew, so did the funding. Currently, Federally Qualified Health Centers are a part of the United States Department of Health & Human Services (DHHS) and are located within the Health Resources and Services Administration (HRSA), Bureau of Primary Care (BPHC).
Strictly for-profit medical centers receive a state-negotiated reimbursement to cover the cost of patient care. However, federally qualified health centers partner with the Center for Medicaid and Medicare Services (CMS) to receive Congressionally-authorized funding that covers the actual cost of patient care. Other sources of funding include third party payment (private insurance payment), direct revenue (cash-paying patients), state funds, local funds, federal funds administered through HRSA and charitable donations.
Role of the Health Center Model
The Health Center model continues to provide an effective means of overcoming barriers to healthcare access, including geography, income and insurance status, and in doing so, improves health care outcomes and reduces health care system costs. Health Centers reduce overall costs of care by helping manage patients’ chronic conditions, which keeps them out of costlier health care settings like hospital emergency rooms. Health Centers are on the front lines of emerging health care crises, providing access to care for our nation’s veterans, addressing the opioid epidemic, and responding to public health threats in the wake of natural disasters.
Community Health Care Systems qualifies as a Patient Centered Medical Home (PCMH), which is a special designation provided to high performing Federally Qualified Health Centers. Essentially, a PCMH provides higher quality patient care at a lower cost than comparable for-profit health centers. This is especially impressive considering that Federally Qualified Health Centers were designed to, and serve, a majority population of patients with chronic health needs and extremely high rates of poverty.
National Health Week 2020
National Health Center Week offers the opportunity to recognize America’s nearly 1,400 health center organizations with over 12,000 service delivery sites, their dedicated staff, board members, patients and all those responsible for their continued success and growth since the first health centers opened their doors more than 50 years ago.
During National Health Center Week, we celebrate the legacy of America’s Health Centers, and their vital role in shaping the past, present, and future of America’s health care system.
Follow us on social media to remain up-to-date with our National Health Center Week events and promotions. You can also visit www.healthcenterweek.org to find events nearest you.
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Additional Reading
- National Assocation of Community Health Centers: http://www.nachc.org/research-and-data/research-fact-sheets-and-infographics/
- Overview of Health Centers Today: ruralhealthinfo.org/topics/federally-qualified-health-centers
- HRSA Fact Sheet: bphc.hrsa.gov/sites/default/files/bphc/about/healthcenterfactsheet.pdf