How To Become A Federally Qualified Health Center (FQHC)

Curious about what it takes to become a federally qualified health center (FQHC)? Here are important details to get you started.

RJ, Associate Consultant, works with ClearPoint customers to improve the efficiency and effectiveness of their performance management processes by leveraging ClearPoint's strategy execution software.

The U.S. healthcare system is designed for efficiency and scale. Medical offices, hospitals, surgery centers, and other facilities operate best when they are at full capacity. Financially, it works when everyone has health insurance as well.

It’s much trickier to run a “well-oiled machine” in rural locations and areas with underserved and poor populations. For these locations, the federal government can provide additional assistance to organizations that have become Federally Qualified Health Centers. We’ve written this article to help you decode that designation and integrate it with your strategic planning so you can take advantage of it for your healthcare organization.

What is a federally qualified health center?

A federally qualified health center (FQHC) is a community-based, nonprofit organization that delivers primary healthcare services to underserved areas and populations. Notably, FQHCs provide these services regardless of patients’ ability to pay, and charge for services on a sliding-fee scale. According to the Health Resources and Services Administration (HRSA), which runs the FQHC-designating program, these health centers provide care to more than 28 million people in the U.S., including one in five living in rural areas and one in three living in poverty.

According to the Health Resources and Services Administration (HRSA), these health centers provide care to more than 28 million people in the U.S., including one in five living in rural areas and one in three living in poverty. Click To Tweet

If the above sounds like your healthcare organization, you might be eligible to gain this designation and reap the benefits offered by the HRSA. Continue reading to learn about some of the federally qualified health center regulations you’ll have to navigate on your journey to becoming a FQHC. And if becoming a FQHC isn't on your radar, check out how one of our healthcare customers run their performance improvement program.

Becoming A Federally Qualified Health Center

Health Center Program Awardees vs. Look-Alikes

Before seeking the FQHC designation, you’ll have to first apply to become either a Health Center Program award recipient or look-alike. Both entities provide the same care, abide by the same requirements, and receive the same benefits (see section below)—the key difference between them is that look-alikes do not receive Health Center Program funding.

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How To Gain Accreditation

You can apply for Health Center Program funding and become an awardee by responding to available funding opportunities, of which there are two types:

  • New Access Point (NAP) funding for operational support for a new health center. When applying, you must propose at least one full-time, permanent NAP site whose main purpose is primary medical care.
  • Service Area Competition (SAC) funding for existing health centers. Award funding is limited to one award per announced service area.

Alternatively, you can apply for the look-alike designation (no funding) through the HRSA Electronic Handbooks (EHBs). Check out the application instructions to get started.

Requirements for either application method are the same—they cover aspects such as staffing, hours of operation, leadership, coverage for medical emergencies, quality improvements, sliding-fee discounting, reporting, budgeting, and much more.

You can review the Health Center Program Compliance Manual for more information, but here are a few notable must-haves:

  • Sliding-fee discounting, where no patient is denied service based on their ability to pay
  • Comprehensive health services, including primary care, preventative care, mental health, dental, hospital/specialty care, substance abuse, etc.
  • Services that cater to an underserved area or population
  • Quality assurance program that promotes ongoing quality improvements
  • At least 51% of board members use the health center as their regular source of healthcare

FQHC Benefits

Whether you become an awardee or look-alike, you’ll gain access to several key benefits:

  • FQHC Prospective Payment System reimbursement for services to Medicare and Medicaid beneficiaries
  • 340B Drug Pricing Program discounts for pharmaceutical products
  • Free vaccines for uninsured and underinsured children through the Vaccines for Children Program
  • Assistance in the recruitment and retention of primary care providers through the National Health Service Corps

How ClearPoint Can Help In Your FQHC Journey

ClearPoint provides a host of relevant features to help healthcare organizations track, report, and improve performance. Looking to the previously mentioned Health Center Program Compliance Manual, ClearPoint can specifically help address the requirements of chapter 10 Quality Improvement/Assurance and chapter 18 Program Monitoring and Data Reporting Systems. Chapter 10 requires health centers to show ongoing quality improvements, while Chapter 18 denotes the need for a system that monitors health center performance and provides the ability to report data to the HRSA.

In the ClearPoint, quality improvement tracking and data monitoring can be achieved in many different ways, including leveraging Gantt charts to efficiently manage project timelines, reminder emails to help your team stay on track and hit deadlines, and customizable charts for visualizing important data and information.

Of course, ClearPoint can do more than just compliance reporting. As strategy execution software, ClearPoint helps healthcare organizations of all sizes effectively execute strategy, efficiently manage projects, and save time on reporting to continually improve quality and abide by exacting federally qualified health center regulations (and similar accrediting bodies).

Interested in using ClearPoint for your FQHC journey? Contact us to learn more!

How To Become A Federally Qualified Health Center (FQHC)