The FQHC Alternative Payment Methodology Toolkit: Fundamentals Of Developing A Capitated FQHC APM

This FQHC APM toolkit is designed for state PCAs to use in developing FQHC alternative payment methodologies (APMs) in collaboration with health centers in their states. The toolkit contains the most recent information the authors have at the time of publication. It should also be noted that this toolkit is informed by the experiences in various states, and that the Medicaid program varies from state to state, so any particular FQHC APM elements described here may not be applicable in your state. While this document was intended for use by PCAs, there are various aspects that could apply to individual health centers. However, each health center’s experience, even in the same state, may vary within an FQHC APM.

Payment, policy and practice are interconnected. While the toolkit focuses primarily on the payment and policy structures that form an FQHC APM, health centers and PCAs will want to consider the systems and supports needed for the associated practice changes.