Of all the different types of healthcare providers, Federally Qualified Health Centers (FQHCs) might be the ones who best understand the importance of being deeply rooted in a community.
After all, FQHCs are also known as community health centers (CHCs) for a reason. They are designed to be a safe haven and source of support for disadvantaged and vulnerable populations who often lack crucial social and economic connections that are tied to improved health outcomes. By building a nurturing community of care around these individuals, FQHCs open up new pathways to healthier, happier, and more integrated life experiences for patients.
But sometimes, FQHCs neglect to build similar relationships for themselves at the organizational level. Just like their patients, FQHCs can often feel isolated and alone in a complex and unfriendly world.
CHCs tend to sit outside the mainstream healthcare policy and reimbursement environment. They are typically operating under significant resource constraints that may limit both their ability to provide key services and their capacity to connect digitally with other entities. And they may be physically isolated in remote rural areas or underdeveloped urban neighborhoods, making it difficult to attract and retain staff or engage in professional development opportunities.
To combat these factors, FQHCs need to make an effort to reach out to the many resources that are, in fact, available to them, said a panel of CHC and payer luminaries in a recent webinar hosted by Yuvo.
“We have to try to bridge the gaps between the different members in the community health space,” said Natalie Lukaszewicz, VP of Network Development and Contracting at Buckeye Health Plan, which works extensively in the community health space in Ohio.
“How do we start bringing everyone together so that we’re all rowing our boats in the same direction? We need to engage with our partners in creative, innovative ways so that we’re being efficient and impactful for the populations we serve. Everyone has to pitch in and work together.”
Doing so isn’t always easy, Lukaszewicz and her fellow panelists acknowledged, particularly when first starting off in the value-based care environment. But FQHCs can begin to rally their resources by prioritizing partnerships with four key players in the space: FQHC associations, payers, local community-based organizations, and administrative experts to set the course for success with value-based reimbursements.
Collaborating with national and state-level FQHC associations
There are a variety of state and national organizations dedicated to helping FQHCs continually improve the quality of care and maintain financial sustainability. Increasingly, these entities are also focused on accelerating the transition to value-based care so CHCs can stay aligned with the larger shift away from fee-for-service.
Working closely with these groups, such as the National Association of Community Health Centers (NACHC) or a local chartered state primary care association, can provide valuable insights and advice for FQHCs seeking to be on the leading edge of the value-based care transition.
“In New York, our primary care association, CHCANYS, offers quarterly meetings and shares best practices for the CHCs across the state,” explained Ari Benjamin, MD, Chief Medical Officer at Joseph P. Addabbo Family Health Center serving areas of Queens and Brooklyn. “We attend those meetings, which are very helpful, and keep us aligned with what’s happening in our local policy environment.”
Ohio’s FQHCs have a similar opportunity to work closely with their local CHC association chapter, Ohio Association of Community Health Centers (OACHC), added Lukaszewicz. “In Ohio, we are engaged with our FQHC association, who has a model arrangement with a large number of FQHCs, to establish a shared savings program with a quality gateway. Year over year, our FQHCs have continued to improve on the bonuses they’re receiving, so we believe that this collaborative approach is very successful for all parties involved.”
FQHCs that don’t yet have strong relationships with the regional association should consider looking into what this type of partnership has to offer. From policy advocacy to public health information and advice about coding, and grant funding, these groups have a wealth of resources available to CHCs in their areas.
Partnering with payers to align incentives
Many payers are heavily invested in assisting their provider partners with the move to value and are willing to work closely with FQHCs to make sure the transition happens quickly, smoothly, and equitably.
“Payers value their FQHCs very much,” asserted Pantelis Karnoupakis, VP of Value-Based Payment Initiatives at Fidelis Care, a New York-based health plan. “We want them to succeed, because then the plan succeeds, too. We have an opportunity to share our knowledge about important factors like appropriate coding, which is critical for correctly allocating resources to the most high-acuity populations. Good coding benefits everyone, so we want our CHCs to work with us around this and other topics.”
Strong partnerships with payers also contribute to more equitable and advantageous value-based care contracts and can set the stage for open conversations about attribution arrangements, shared savings calculations, and clinical benchmarks.
Harnessing the resources of community-based organizations
FQHCs aren’t the only ones working tirelessly to provide help and hope to vulnerable populations. Community-based organizations (CBOs) operate concurrently to address the social determinants of health, such as food and housing security, transportation, education, loneliness in seniors, and access to other social services.
“CBOs have an equally important role in health,” said Karnoupakis. “But the healthcare system doesn’t have a good pipeline for bringing these resources and this data into our world. All of our clinical data is just the tip of the iceberg in terms of what we need to drive an individual toward more positive decision-making.”
“In a big state like New York, which is both very urban and very rural, we need to understand how our communities interact with CBOs and increase our ability to harness those resources and amplify the work we’re doing on the clinical front in our CHCs.”
Since value-based care provides incentives to further integrate non-clinical care with the traditional healthcare system, these models are an ideal way for FQHCs to bolster their existing partnerships and build new bonds with local CBOs.
Lightening the lift with administrative and contracting support from an IPA
In addition to working more closely with state FQHC associations, CHCs have the opportunity to come together with their fellow health centers in an independent provider association (IPA) to travel together down the path to value-based care.
As part of an IPA, FQHCs can learn more about the policies around value-based care, open up doors to more attractive contracts, amplify their voices when negotiating with payers, and feed off each other’s creativity and innovation when engaging in practice redesign initiatives.
In states like New York, for example, where only certain entities can legally contract to shoulder downside risk, IPAs are a vital bridge to the more advanced, more lucrative end of the spectrum.
IPA members can also get help with the administrative challenges of participating in value-based care, including generating a better understanding of coding and patient attribution, how to calculate benchmarks, and how to use data analytics tools to gain visibility into practice patterns.
In conjunction with efforts to collaborate more closely with payers, CBOs, and CHC associations, becoming a member of an IPA can cement an FQHC’s place in this vibrant, supportive, newly evolving community of value-driven healthcare.
In conclusion, FQHCs have an array of opportunities to establish the right partnerships and see success with value-based care. Once they do so, success with their clinical and financial goals is closer than ever.