Federally Qualified Health Center (FQHC) - Health Insurance

What Is a Federally Qualified Health Center (FQHC) in Health Insurance?

<lingo>A federally qualified health center (FQHC) is a type of community health care provider. Such a health care provider receives government funding by way of a unique reimbursement designation from the Health Resources and Services Administration (HRSA). These centers typically service underserved populations or areas and offer a sliding fee scale to patients. They principally provide outpatient medical services, such as doctor’s visits, vaccines, routine preventative screenings, dental services, mental health and substance abuse services, and self-management trainings and therapies. Because FQHCs receive government funding, they must meet a specific set of stringent requirements outlined by the government and have ongoing quality assurance programs.</lingo>

Federally Qualified Health Centers Clearly and Briefly Explained

Federally qualified health centers (FQHCs) serve as safety net health care providers in underserved areas. Examples of FQHCs include migrant health centers, community health clinics, homeless health care clinics, health center program “look-alikes,” and public housing primary care centers. Some tribal organization outpatient clinics are also included under the umbrella of federally qualified health centers. 

As a result of primarily serving underserved areas, FQHCs are often located in rural regions. Altogether, the HRSA Health Center Program estimates that over 27 million individuals rely on these health centers for their regular medical care. This includes 1 in every 5 rural residents. 

<twitter>A federally qualified health center (FQHC) is a type of community health care provider.</twitter>

Under the Medicaid and Medicare programs, FQHCs qualify for government reimbursement systems. Currently, nearly 1,400 community health centers are funded by the HRSA and receive funding.

In order to qualify for such funding, organizations must be public or nonprofit, community-based, and provide a range of comprehensive primary care medical services. It is important that they offer services to everyone, regardless of someone’s ability to pay. They must be located in populations or areas that are medically underserved. 

Furthermore, determining payment requirements for patients must be done using a sliding scale. The individual provides their income, and a fee scale determines how much they will be discounted for medical services. Finally, the organization must have an ongoing quality assurance program and have a governing board of directors made up mostly of patients. 

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