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 Excellence in Mental Health and Addiction Act, one of the most significant developments in behavioral health funding in decades, was designed to increase Americans’ access to community mental health and substance use treatment services via the creation of Certified Community Behavioral Health Centers (CCBHCs) in 8 states, while improving Medicaid reimbursement for these services.
In 2017, health centers in Washington worked with the Washington Association of Community and Migrant Health Centers (WACMHC) and Washington State Medicaid (Health Care Authority or HCA) to launch a capitated FQHC APM that incorporates quality metrics.
From 2011 to today, two organizations devoted to serving the health of the community developed and grew into a strong partnership through transparency and collaboration.
Piedmont Health Services (PHS) is a Community Health Center in North Carolina with twelve locations across the state, two of which are designated as PACE service sites.
Provider Health Link, an Independent Practice Association (IPA) in Georgia established by the Georgia Primary Care Association, has much to teach health centers considering becoming partners towards financial and quality incentives.
Sunset Community Health Center, Inc., located in the southwest corner of Arizona, is the largest provider of primary care in its county, serving approximately 28,000 patients across nine sites.