How Can FQHCs Can Come Together for Value-Based Payment Success?

There’s no question—Federally Qualified Health Centers (FQHCs) play a vital role in our nation’s healthcare delivery system. They provide care and services to more than 28 million patients annually, many of whom are uninsured, struggling with poverty, or located in rural areas, according to the National Association of Community Health Centers (NACHC).

However, many questions surround FQHCs’ ability to navigate the industry’s shift toward value-based payment (VBP) models successfully. Understanding where FQHC leaders are in their planning and strategies related to VBP was the purpose behind a recent Porter Research survey of more than 50 FQHC clinical, operational, and financial leaders.

Key findings from the study indicate:

• 85% of FQHCs expect VBP to grow in the next 12 years
• 77% are not confident in their current VBP strategies
• 64% say they are likely to change their strategies

According to a CEO of a large FQHC in Ohio, “Value-based payment models are shifting. We used to get paid on the quality indicators submitted on the claim. We either met the measure and got a bonus payment, or we didn’t. Things are shifting now, and payers are setting participation criteria that forces us to assume a portion of the risk. The formulas are crazy complicated, and the game is definitely changing.”

How can FQHCs work closely together to do more to improve their likelihood of building successful VBP strategies?

Working together for progress

 

According to the research, the majority of FQHCs have already established strategic partnerships with like-minded organizations, such as HCCNs, PCAs, and ACOs. However, there is more FQHCs can do and accomplish if they choose to work more directly with each other—across geographic and operational differences.

 

Until recently, working together with other FQHCs was typically a result of one-off, personal relationships that leaders formed over coffee at an industry conference. However, at the national level, there is limited structure in place that enables all FQHCs, regardless of their location or level of technological skill, to seamlessly and securely exchange data with each other. Establishing this could help them build and understand benchmarks, care strategies, and operational KPIs better.

 

According to Doug Smith, executive vice president of Presbyterian Medical Services (PMS), “It’s essential that FQHCs work together more closely. With greater collaboration, we can better inform each other of best practices and approaches to important initiatives like social determinants of health (SDOH), adverse childhood experiences (ACEs), chronic condition management, and expanding care service lines.”

 

As it provides the most-used EHR platform among FQHCs, NextGen Healthcare saw an opportunity to help make a difference and bring FQHCs together, no matter which EHR system they use. Late last year, NextGen Healthcare launched the very first nationwide Community Health Collaborative. Since that time, the Collaborative has been growing and delivering powerful insights to FQHC leaders.

What is the NextGen Community Health Collaborative?

 

The NextGen Community Health Collaborative is a vendor-agnostic system that collects data from participating FQHCs and leverages advanced technology to give access to both clinical and operational benchmarks that help all FQHCs:

 

• Better understand what their peers are doing to improve the health of their communities
• Identify best practices that they may be able to apply to their own communities
• Discover new programs, such as behavioral health, that are delivering positive results for other like-sized organizations
• Better achieve their mission through data-driven insights

For example, NextGen Healthcare often works with a state’s largest FQHC. This FQHC is then able to share data with other, often smaller, community centers around their state, which were not able to easily gain access to important data from larger FQHCs. By participating in the NextGen Community Health Collaborative, organizations now have access to the most relevant data, health dashboards, and clinical research insights to help them improve outcomes. Plus, they have a way to easily connect with their peers to collaborate on these insights.

The data makes the difference

Because NextGen Healthcare represents such a large portion of the FQHC market, the database of blinded information is statistically relevant, and the tool can generate never-before-accessible benchmarks and insights that stretch beyond simple payer metrics and UDS metrics. The key to success is access to next-level information, such as no-show rates, patient acuity, level of clinicians used for certain programs, more social determinants of health, etc.—all of which are uniquely complex within FQHC-specific workflows.

Get engaged

 

To learn more about the NextGen Community Health Collaborative, read this brochure

 

For more information about the study results and industry-wide initiatives underway at NextGen Healthcare, you can download the research report, check out the research infographic, and/or listen to the research webinar hosted by Porter Research and NextGen Healthcare entitled “The Perfect Storm: Why FQHC Leaders Must Choose Wisely.”