Idaho Develops a Medicaid Value-Based Payment Model for its FQHCs, Based on Cost and Quality

This case study provides a description of Idaho’s new value-based payment model for federally qualified health centers (FQHCs), launching in January 2020. The Community Health Center Network of Idaho, which formed in 2012 with 14 FQHCs, has engaged in VBP contracts with commercial payers since 2014 and also operates a Medicare accountable care organization; this foundation and experience should help FQHCs thrive under the new payment model. The case study details how the Healthy Connections Value Care (HCVC) program will operate, including perspectives from the state Medicaid agency and FQHCs. This provides an example of the 3-layered payment reform FQHCs are engaging in (base payment + care management + savings dependent on total cost of care and quality).