Considering Medicaid Payment to Federally Qualified Health Centers

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October 2017

Medicaid is the largest source of revenue for federally qualified health centers (FQHCs), accounting for 44 percent of their funding. The Balanced Budget Act of 1997 established a federal Medicaid payment method for FQHC services, called the prospective payment system (PPS). States can implement an alternative payment methodology, but must assure that alternative methods pay rates equivalent to the FQHC PPS. FQHCs that are part of managed care networks must also be paid a minimum FQHC PPS rate. Many states are using alternative payment methods to allow health centers to participate in value-based pay initiatives such as accountable care organizations, episode-based payments, patient-centered medical homes, and pay for performance.

This slide deck contains the presentations of three panelists invited to discuss Medicaid payment for FQHCs at MACPAC’s October 2017 meeting:

  • Nadereh Pourat, director of research at the UCLA Center for Health Policy Research;
  • Ralph Silber, chief executive officer of the Community Health Center Network; and
  • Claudia Schlosberg, senior deputy and state Medicaid director for the Department of Health Care Finance in Washington, DC.

Publication Type: Presentations

From: October 2017 MACPAC Public Meeting

Tags: federally qualified health centers (FQHCs), fee for service, income, managed care, payment, value-based purchasing