LEAD ACO Model: Reviving the Promise of PC Flex

CMS recently announced the Long-term Enhanced ACO Design (LEAD) Model, positioning it as the follow-up to ACO REACH, which sunsets at the end of 2026. This 10-year voluntary model kicks off January 1, 2027, and promises the longest ACO model yet. LEAD isn’t just a REACH sequel – it is breathing new life into the goals […]

$50B Rural Health Transformation Opportunity: What FQHCs and Rural Providers Need to Know

The One Big Beautiful Bill Act, signed into law earlier this summer, created the Rural Health Transformation (RHT) Program, an initiative launched by the Centers for Medicare & Medicaid Services (CMS) to help rural communities redesign their healthcare delivery systems, expand access to quality care, develop the workforce, and improve health outcomes through innovation and support […]

Federally Qualified Health Centers Leveraging Analytics to Enable Value-Based Care Success

Federally Qualified Health Centers (FQHCs) are a crucial health care access point for underserved and uninsured communities. Yet, FQHCs face challenges with maintaining financial stability when relying solely on revenue from Prospective Payment System (PPS) rates, which tend to lag behind rising expenses. To diversify their revenue streams, FQHCs should consider pursuing Value-Based Care (VBC) […]

Why Most FQHC Strategic Plans Fail—and How to Build One That Delivers

Strategic planning has always been a requirement for Federally Qualified Health Centers (FQHCs). In today’s rapidly evolving market, the right strategic plan—centered on value-based payment (VBP) and value-based care—is also a competitive differentiator. CMS is accelerating the shift to VBP, and managed care plans are becoming more selective with their partnerships. FQHCs that treat strategic […]

5 Strategies to Enhance FQHC Performance and Financial Sustainability

Federally Qualified Health Centers (FQHCs) play a critical and innovative role in delivering comprehensive care to underserved communities, yet they face ongoing challenges in sustaining financial health and operational efficiency. With Medicaid and Medicare margins tightening as rate increases lag behind inflation, and expected reductions in Medicaid and ACA marketplace membership to cause a growth […]

Four Key Considerations For Recent FQHC New Access Point Applicants

In summer 2024, the Health Resources and Services Administration (HRSA) released a long awaited Notice of Funding Opportunity for Health Center Program New Access Point (NAP) applications allowing qualified entities to apply for Federally Qualified Health Center (FQHC) designation. It is anticipated that HRSA will award 77 grants, of up to $650,000 each, with the […]

Creating Successful Partnerships Between Health Systems and FQHCs

In a healthcare environment that is increasingly recognizing the importance of a value-based approach to healthcare delivery, partnerships between health systems and Federally Qualified Health Centers (FQHCs) provide a tremendous opportunity for both entities to invest resources thoughtfully, efficiently, and strategically to address community health needs. For health systems that own or are participants in […]

Key Considerations for the Final Round of California CITED Funding

Capacity and Infrastructure Transition, Expansion and Development (CITED) is an incentive payment model available to Enhanced Care Management (ECM) and Community Supports (CS) providers which includes Federally Qualified Health Centers (FQHC), county and social services agencies, community clinics, and other community-based entities. CITED is one component of the Providing Access and Transforming Health (PATH) Initiative […]