Community Health Centers, Medicaid, and payment reform

Payment reform is a critical issue in Medicaid policy, reflecting a wider effort among all payers to reduce spending while improving outcomes. But Medicaid faces unique challenges, including a low-income population with disproportionate health care needs.  At the same time, Medicaid enrollment has soared  in states that have implemented the Affordable Care Act’s Medicaid expansion. To meet these challenges, several Medicaid expansion states are now beginning to adapt the special federal payment policies that apply to the nation’s nearly 1,400 community health centers. 

With Commonwealth Fund support, the Geiger Gibson/RCHN Community Health Foundation Research Collaborative examined payment reform in these five states during 2015 in a report now available at the George Washington University Milken Institute School of Public Health website. According to the article, the states under review are moving toward alternative payment models that can satisfy FQHC rules while still improving efficiency and achieving greater integration of value-based payment principles such as global payment and the use of performance measures.