Question

What is an FQHC (Federally Qualified Health Center)? What types of services/healthcare might they provide? (I.e. mental health, primary care, dental, OBGYN, pediatrics, etc.) What insurance(s) might they accept? Will they help persons who are not insured or are underinsured? Do they offer sliding fees? What is the FQHC closest to you?

Minimum 400 words pls

Please add at least 5 references with in-text citations

Ref:

An Introduction to Community Health. 8th ed.

McKenzie, J.F., Pinger, R.P., Kotecki, J.E.

Jones & Bartlett Learning. 2015  

ISBN: 978-1284036596

Answer 1

FQHC(Federally Qualified Health Center) is a community-based healthcare organization that provides comprehensive primary care and preventive health care like oral and other healthcare, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status. They play a critical role in the health care safety net. (Doty, Abrams, Stremikis, Beal 2010). FQHCs are also called Community/Migrant Health Centers (C/MHC), Community Health Centers (CHC), and 330 Funded Clinics. They are health professional shortage facilities as per their design.

FQHCs are non-profit Community directed providers and provide services to remove common barriers to care by serving communities who otherwise challenged by barriers like financial, geographic, language, cultural and other barriers. They are usually located in high demand areas or areas identified as having elevated poverty, higher than average infant mortality, and where physician shortage is common. FQHC are community-directed, with patients making up more than half of their governing boards and are open to all residents, regardless of insurance status or ability to pay. (Bureau of Primary Health Care, 2013)

FQHCs design services to fit the special needs and priorities of the particular communities and provide services in a linguistically and culturally competent manner. Their services include comprehensive primary and other health care services that help their patients access care, such as transportation, translation, and case management thus they reduce health disparities and improves the patient outcomes. Economically they reduce costly emergency, hospital, and speciality care, and saving the health care system $24 billion a year nationally. They provide cost-effective care. (Bureau of Primary Health Care, 2013)

Based on the CMS factsheet (2018) the FQHC services include:

• Physician services
• Services and supplies “incident to” the services of physicians
• Nurse practitioner (NP), physician assistant (PA), certified nurse-midwife (CNM), clinical psychologist (CP), and clinical social worker (CSW) services
• Services and supplies “incident to” the services of NPs, PAs, CNMs, and CPs
• Medicare Part B-covered drugs furnished by an “incident to” services of an FQHC practitioner
• Visiting nurse services to the homebound in an area where CMS determined there is a shortage of home health agencies and
• Outpatient diabetes self-management training (DSMT) and medical nutrition therapy (MNT) for patients with diabetes or renal disease furnished by qualified practitioners of DSMT and MNT

The services provided by FQHCs are regardless of the ability to pay. The charges for services are on a community board approved sliding-fee scale, it is calculated based on patients' family income and size. FQHCs must comply with Section 330 program requirements. ( bphc.hrsa.gov. 2017). The FQHCs obtain from the Federal government cash grant, cost-based reimbursement for their Medicaid patients, and malpractice coverage under the Federal Tort Claims Act (FTCA) for serving all patients regardless of ability to pay. ( FTCA) 2018)

There is another category of health centers designed by The government as "FQHC Look-a-likes" , which, may 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. (Department of Health and Human Services. 2011)

The FQHC Look-a-likes receive cost-based reimbursement for the Medicaid services provided but do not receive malpractice coverage under FTCA or a cash grant. They also qualify as health professional shortage areas automatically.

The acceptance of the patient regardless of their ability to pay is a key requirement of the Health Center Program. Some health centres may refuse service to patients who have violated health centre policies. FQHCs must establish a sliding fee discount program as they are nonprofit, community-based, public organization.

References:

1. 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.

2. www.nachc.org/wp-content/uploads/2015/06/United_States_FS_2014.pdf

3. https://www.cms.gov/Outreach-and-Education/Medicare...MLN/.../fqhcfactsheet.pdf

4. "Health Center Program Compliance Manual" (PDF). bphc.hrsa.gov. 2017. Retrieved 2018-03-27

5. About the Federal Tort Claims Act (FTCA)". bphc.hrsa.gov. Retrieved 2018-03-28

6. Federally Qualified Health Center". Department of Health and Human Services. Centres for Medicare and Medicaid Services. November 2011.