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Community health centers and Medicaid payment reform: emerging lessons from Medicaid expansion states

Series Title(s):
Issue brief (Geiger Gibson / RCHN Community Health Foundation Research Collaborative)
Author(s):
Shin, Peter, author
Sharac, Jessica, author
Barber, Zoe, author
Rosenbaum, Sara, author
Contributor(s):
Geiger Gibson / RCHN Community Health Foundation Research Collaborative, issuing body.
Geiger Gibson Program in Community Health Policy, issuing body.
George Washington University, issuing body.
Milken Institute School of Public Health, issuing body.
Publication:
[Washington, D.C.] : George Washington University School of Public Health and Health Services, October 11, 2016
Language(s):
English
Format:
Text
Subject(s):
Community Health Centers -- economics
Community Health Services -- economics
Health Care Reform -- economics
Insurance, Health, Reimbursement -- economics
Medicaid -- economics
Prospective Payment System -- economics
Reimbursement Mechanisms
State Government
Humans
United States
United States.
Genre(s):
Technical Report
Abstract:
Community health centers represent a major source of primary health care for the nation's Medicaid beneficiaries. Because the Federally Qualified Health Center (FQHC) payment system is encounter-based, health centers and Medicaid agencies in ACA expansion states are actively pursuing payment reforms that will enable health centers to adopt strategies that can more effectively respond to the considerable and complex health and social needs of people served by health centers, and more efficiently address the surging volume of patient care. In five expansion states whose alternative payment experiments are underway, health centers and Medicaid agencies are testing payment alternatives, such as global payments, that link payment to performance while ensuring that the FQHC hold-harmless standard is met and that total revenues do not fall below the FQHC floor. These alternative payment approaches enable health centers to test new strategies to address the needs of their patients, while enabling state agencies to align these strategies more closely with broader payment reform efforts.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
Extent:
1 online resource (1 PDF file (18 pages))
Illustrations:
Illustrations
NLM Unique ID:
101735556 (See catalog record)
Series Title(s):
Issue brief (Geiger Gibson / RCHN Community Health Foundation Research Collaborative)
Author(s):
Shin, Peter, author
Sharac, Jessica, author
Barber, Zoe, author
Rosenbaum, Sara, author
Contributor(s):
Geiger Gibson / RCHN Community Health Foundation Research Collaborative, issuing body.
Geiger Gibson Program in Community Health Policy, issuing body.
George Washington University, issuing body.
Milken Institute School of Public Health, issuing body.
Publication:
[Washington, D.C.] : George Washington University School of Public Health and Health Services, October 11, 2016
Language(s):
English
Format:
Text
Subject(s):
Community Health Centers -- economics
Community Health Services -- economics
Health Care Reform -- economics
Insurance, Health, Reimbursement -- economics
Medicaid -- economics
Prospective Payment System -- economics
Reimbursement Mechanisms
State Government
Humans
United States
United States.
Genre(s):
Technical Report
Abstract:
Community health centers represent a major source of primary health care for the nation's Medicaid beneficiaries. Because the Federally Qualified Health Center (FQHC) payment system is encounter-based, health centers and Medicaid agencies in ACA expansion states are actively pursuing payment reforms that will enable health centers to adopt strategies that can more effectively respond to the considerable and complex health and social needs of people served by health centers, and more efficiently address the surging volume of patient care. In five expansion states whose alternative payment experiments are underway, health centers and Medicaid agencies are testing payment alternatives, such as global payments, that link payment to performance while ensuring that the FQHC hold-harmless standard is met and that total revenues do not fall below the FQHC floor. These alternative payment approaches enable health centers to test new strategies to address the needs of their patients, while enabling state agencies to align these strategies more closely with broader payment reform efforts.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
Extent:
1 online resource (1 PDF file (18 pages))
Illustrations:
Illustrations
NLM Unique ID:
101735556 (See catalog record)