Community Health Centers (CHCs), also known as Federally Qualified Health Centers (FQHCs), are community-based health care providers that are vital lifelines in medically underserved areas.
Funded by the Health Resources and Services Administration (HRSA), they provide comprehensive primary and preventative care, dental services, mental health and substance use services, and supportive services like transportation and translation, for patients to access health care. In addition, we have supported more than 20 states to write their CCBHC planning grant applications to initiate a state-run CCBHC model. Most recently, we had 100% success rate for our FY23 planning grant applications, resulting in four states receiving one year planning grants to build a state-run CCBHC model.
FQHCs partner with HMA for expert guidance in strategic planning, board development, finance and operations, clinical improvement, understanding federal and state policy, advancing health equity, grant writing, community health needs assessment, expanding practice scopes, and executive coaching. HMA’s consultants bring extensive real-world and leadership experience and expertise working with FQHCs prior to joining HMA, offering FQHCs a range of services and support with:
- Health equity initiatives
- Financial reimbursement and diversification
- Solutions for complex patient populations such as individuals who are uninsured, low health literacy, non-citizens, justice-involved, homeless
- Responding to rapidly evolving Medicaid/Medicare policy
- Addressing difficult workforce recruitment and retention efforts
In addition to working with FQHCs, HMA works collaboratively with multiple Primary Care Associations (PCAs) to leverage our expertise benefiting multiple FQHCs.
How HMA can help
HMA’s FQHC value-based payment team has extensive experience working with PCAs, Health Center Controlled Networks, and FQHCs to form integrated delivery systems focused on the Medicaid and Medicare populations to help them progress along the CMS Framework for Value‐based Payments commensurate with their readiness. Current and recent projects have included PCAs and FQHCs in New York, Illinois, Rhode Island, Oklahoma, Wisconsin, Missouri, North Carolina, Montana, and Indiana.
HMA Principal Art Jones, MD, MPH, was the architect of the first FQHC APM in the country that transitioned payment from fee-for-service to capitation. It was adopted by the FQHC he led as CEO and four other Chicago-area FQHCs in 2001. In 2017, HMA helped the Washington Health Care Authority, the Washington Primacy Care Association, and its FQHC members develop a capitated FQHC APM. Since then, HMA has worked with PCAs and FQHCs in New York, Illinois, Rhode Island, Oklahoma, Wisconsin, Missouri, North Carolina, Montana, and Indiana to develop their own capitated FQHC APMs.
HMA Principal Art Jones, MD, MPH, partnered with five Chicago area FQHCs and five hospitals to establish Medical Home Network in 2011, the prototype clinically integrated network focused on underserved communities. Driven to solve social drivers of health and seeking to demonstrate that in the safety net, technology can be deployed to deliver superior outcomes, the network has grown to include 14 FQHCs and three health systems with more than 180,000 Medicaid beneficiaries with delegated responsibility for care management and global risk. It supports 80 FQHCs in eight states in Medicare ACOs. Another HMA principal was CEO of one of the founding FQHCs at the network’s inception. This model has been replicated in other states to benefit communities of need.
FQHCs in some states receive general revenue funding to support operations. HMA has extensive experience with federal-directed payment program rules that can secure matching federal funds that at least double and sometimes as much triple total funding depending on the state’s federal match rate for Medicaid. Directed payment programs require a value-based payment component. HMA has worked with three state PCAs to develop their programs.
HMA consultants assist FQHCs and their clinically integrated networks in assessing the value-based payment arrangements being offered by managed care plans and proactively designing proposals to take to payers. In many cases, HMA joins in active negotiations with the payer.
HMA has several clinically licensed consultants with experience working at and with FQHCs in their pursuit of value-based care. This includes assisting in NCQA Patient-Centered Medical Home certification, implementing care management programs, and designing and implementing new clinical models of care made uniquely financially feasible under APMs.
HMA has several experienced consultants helping individual FQHCs, State PCAs, and FQHC-led clinically integrated networks with their strategic planning process.
HMA has consultants focused on helping providers, including FQHCs, improve their billing and collections systems to improve cash flow and revenue.
HMA experts are uniquely positioned to help FQHCs and other organizations develop strategies and write for New Access Point and Service Area Competitions.
We believe in a data-driven approach to drive actionable insights. We start with an efficient assessment of your current state and prepare a roadmap for success. After our thorough and rapid assessment, our consultants work with your organization on any aspect of implementation to ensure a sustainable, high-performing empanelment environment that drives operational quality and optimizes
current and future revenue streams. A high-performing empanelment environment leads to optimized PCP continuity of care, accountable PCP and care teams driving clinical quality improvement, readily available appointment slots, and patient retention and productivity goals.
No matter the size, HMA empowers FQHCs to thrive in an ever-changing healthcare landscape. With deep expertise at every level, HMA teams partner with FQHCs nationally to address a wide range of operational challenges, including designing innovative school-based care, and expanding community health centers, optimizing scheduling and empanelment, integrating behavioral health care and strategically adopting telehealth solutions, we help FQHCs seize opportunities. Our experience extends to selecting and implementing cutting-edge IT systems for population health management, optimizing participation in the 340B program, and maximizing workforce capacity. HMA is dedicated to ensuring that FQHCs deliver exceptional care to those who need it most.
State PCAs frequently ask HMA to speak on various value-based payment-related topics at annual conferences.
Project Spotlight
Community Health Center, New York
HMA assisted the community health center in creating its strategic approach to value-based care. The project included analysis of current clinical and financial performance under managed care arrangements, workforce optimization, and opportunities to identify shared savings on total cost of care.
Health Center Strategic Planning, California
HMA worked with the board of directors, community stakeholders, clinicians, and staff to create a theory of change and then identify internal and external opportunities for expansion, quality improvement, and financial growth.
Community Health Center Service Area Competition (SAC) Grant, Ohio
HMA supported a CHC in completing its needs assessment and writing its SAC grant.
PACE readiness, Illinois
HMA consulted with an FQHC in Illinois to analyze, plan for, and apply to open a Program for All-Inclusive Care for the Elderly (PACE) focused on the Latinx population.
Learn more about our work
Contact our experts:
Warren J. Brodine
Principal
Melissa Corrado
Principal
Iliana Gilman
Principal
Jill Kemper
Associate Principal
Margaret Kirkegaard
Principal
