Practice analysis

1. NURS 581: PRACTICE
ANALYSIS PRESENTATION
Kayci Thomas, NP
Student

2. INTRODUCTI
ON –
To certify as an FQHC, a facility must:
• Provide comprehensive services
• Have an ongoing quality assurance program
• Meet all health and safety requirements
• Not concurrently qualify as a rural health clinic
• Meet all requirements of section 330 of the PHA (Centers for Medicare & Medicaid Services, 2019, p. 3)
Examples of a FQHC:
• Community health centers
• Migrant health centers
• Healthcare for the homeless health centers
• Public housing primary centers
• Health center program “look alikes”
• Outpatient health programs or facilities operated by a tribe or tribal organization or by an urban Indian
organization (Centers for Medicare & Medicaid Services, 2019, p. 2)
 My goal is to attain employment at a FQHC after graduation.
This practice setting allows for advancing healthcare by providing medical services to
underserved populations such as those stricken by poverty. It aims to narrow the gaps in
healthcare for these populations.
FEDERALLY
QUALIFIED HEALTH
CENTER (FQHC)

3. ADVANTAGES
Offers comprehensive services including dental and mental
health
Receives Federal Government Funding
Enhanced program in Medicare and Medicaid reimbursement
Coverage in medical malpractice through the Federal Tort
Claims Act
Eligible to purchase non-prescription and prescription
medications for outpatients through the 340 B Federal Drug
Pricing Program
Access to National Health Service Corps
Access to the Vaccine for Children program
Eligible for various other federal programs and grants
Access to on-site eligibility workers to provide Medicaid and
CHIP enrollment services
Access to National Health Service Corps or NHSC dental,
medical, and mental health providers
(Hurtt Family Health Clinic, 2017)

4. CHALLENGE
S
 Increase in number of patients
served (Rosenbaum, et al., 2019)
Funding relies heavily on Medicaid
and grants and increases in funding
are major determinants of expansion
(Rosenbaum, et al., 2019)
Time limitations
Comorbidity management
Duplicate testing due to lack of
information
Shortage of qualified clinicians
Public health crises such as the
opioid epidemic (HealthConnect
Alaska, n.d.)

5. FINANCES
Medicaid and Medicare reimbursement determined through FQHC
Prospective Payment System (PPS)
Medicare reimbursement:
Must include an FQHC code on claim
Medicare pays claims at 80% of the lesser of the FQHC charges
based on payment codes or the FQHC PPS rate
Coinsurance is 20% of the lesser of the FQHC’s charge for the
specific payment code or the PPS rate
Excludes certain preventive services.
FQHCs set their own charges for services
Federal funding through Health Center Program (330 Grant)
Some states provide funding – Louisiana does not
(National Association of Community Health Centers, 2020).
(Centers for Medicare and Medicaid Services, 2019, p. 4)

6. OUTCOMES
 Served more than 30 million people – underserved individuals
 1 in 3 people living in poverty
 1 in 5 rural residents
 Play a major role in addressing emergent public service needs
 COVID-19
 Played a vital role in providing tests, vaccines, and treatments
 Opioid crisis
 Provided substance use disorder services to nearly 286,000
 Provided Medication Assisted Treatment to 184,000 nationwide
 Mental health
 98% of all centers offer mental health services
 HIV
 Diagnosis, treatment, prevention, and response
 2.7 million visits for HIV testing
 Quality Improvement
 77% of health centers achieved Patient-Centered Medical Home recognition
 Delivers strong patient outcomes at lower costs
 79% met or exceeded national clinical benchmarks in 2020 with more than half reporting improvements in 5 or more clinical
quality measures
 Healthcare model decreases costly care choices such as ER visits
 Patients had lower spending compared to non health center patients
(Human Resources and Services Administration, 2022a)

7. CONCLUSION
Play a major role in providing quality care
for underserved populations
Aim to bridge the gap in healthcare for
these population by providing
comprehensive care
I still wish to work at this type of facility
upon graduation

8. REFERENCES
Centers for Medicare & Medicaid Services (2019). Federally Qualified Health Center. Centers for Medicare and Medicaid Services. Retrieved Saturday, April
15 from: https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/FQHC-Text-Only-Factsheet.pdf
HealthConnect Alaska (n.d.) Federally Qualified Health Centers. HealthConnect Alaska. Retrieved Monday, April 17, 2023 from:
https://www.healtheconnectak.org/index.php/who-we-serve/federally-qualified-health-
centers#:~:text=FQHCs%20face%20many%20of%20the,crises%2C%20like%20the%20opioid%20epidemic.
Human Resources and Services Administration (2022a).Health Center Program Impact and Growth. HRSA Health Center Program. Retrieved April 15, 2023
from: https://bphc.hrsa.gov/about-health-centers/health-center-program-impact-growth
Human Resources and Services Administration (2022b). What is the Federal Tort Claims Act? HRSA Health Center Program. Retrieved April 15, 2023 from:
https://bphc.hrsa.gov/initiatives/ftca/what-ftca
Hurtt Family Health Clinic (2017) What are the benefits of being a Federally Qualified Health Center (FQHC)? Hurtt Family Health Clinic. Retrieved Saturday,
April 15, 2023 from: https://www.hurttclinic.org/benefits-federally-qualified-health-center-
fqhc/#:~:text=Access%20to%20the%20Vaccine%20for,medical%2C%20and%20mental%20health%20providers
National Association of Community Health Centers (2020). Federal Grant Funding. National Association of Community Health Centers. Retrieved Monday,
April 17, 2023 from: https://www.nachc.org/focus-areas/policy-matters/health-center-funding/federal-grant-funding/
National Committee for Quality Assuarance (2023). Patient Centered Medical Home Recognition. NQCA. Retrieved Monday, April 17, 2023 from:
https://www.ncqa.org/employers/ncqa-programs-of-interest-to-employers/patient-centered-medical-home-
recognition/#:~:text=NCQA's%20Patient%2DCentered%20Medical%20Home%20(PCMH)%20Recognition%20program%20was,quality%20improvement%20is%
20a%20priority.
Rosenbaum, S., Sharac, J., Shin, P., & Tolbert, J. (2019). Community Health Center Financing: The Role of Medicaid and Section 330 Grant Funding
Explained. KFF. Retrieved Monday, April 17, 2023 from: https://www.kff.org/medicaid/issue-brief/community-health-center-financing-the-role-of-
medicaid-and-section-330-grant-funding-explained/