Last week, The Geiger Gibson Program in Community Health published two new articles highlighting important opportunities to ensure the sustainability of community health centers (CHCs), which provide high-quality, comprehensive health care services in over 14,000 communities across the United States.
The first article, published on Health Affairs Forefront, examines the history of community health center payment reform over the past three decades, discusses the core principles that guide the current prospective payment system (PPS) system, and presents evidence from a six-month study supported by Episcopal Health Foundation, exploring CHC engagement in payment reform and innovation. Conversations with CHCs and Primary Care Associations (PCAs) revealed extensive CHC interest in value-based payment innovations that fundamentally alter the way in which Medicaid revenue flows to health centers. The report also makes recommendations aimed at ensuring that these efforts at moving to alternative payment methods (APMs) rest on a solid foundation. The full article, Community Health Centers and Medicaid: A Deeper Dive Into FQHC Alternative Payment Reform, can be read here.
The second article, produced in partnership with The Commonwealth Fund, flags modifications needed to the Biden administration’s new proposed Marketplace rules in order to ensure that people enrolled in qualified health plans are able to maintain access to essential community providers as defined under the ACA, including CHCs and other key providers. Under the proposed rules, Marketplace plans will still be permitted to exclude two-thirds of safety-net providers and a majority of CHCs in their service areas. The authors argue that the ACA envisions full inclusion, and that such a change is key to ensuring access to covered services. The article points out that coverage through qualified health plans will only grow in importance to both people and providers as states begin the enormous task of winding down Medicaid’s continuous enrollment guarantee, in effect since March 2020. Strengthening Marketplace Network Rules for Essential Community Providers Is a Matter of Health Equity can be read here.
Please share these reports widely, and visit the full archive of reports and articles by the Geiger Gibson team here.