JSI’s Rachel Tobey Weighs in on Changing Role of FQHCs

October 30th, 2019 | News

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Director of JSI’s California Office, Rachel Tobey, has been quoted in an article exploring the changing role of Federally qualified health centers – or FQHCs.

The article, Collide or collaborate? Community health centers and hospitals work through their overlap, appears on the ModernHealthcare.com website.

The article highlights the transformation of FQHCs from smaller clinics to significant businesses in the healthcare industry and how some hospitals are grappling with the change.

“Underlying the relationship is increased competition for the same patient population,” writes author, Susannah Luthi. “Over the past three decades, Medicare, Medicaid and commercial insurance have become the dominant payers of community health centers’ patients.”

By law, community health centers receive cost-based prospective payments for Medicaid. California, for example, reimburses FQHCs for the difference between the managed-care plan’s payment and the federal fee-for-service rate. In the article, Rachel Tobey, Director of JSI’s California office, weighs in on health care financing and alternative payment models.

“Alternative payment models would allow community health centers to combine services for a patient during one visit, policymakers would need to make adjustments so a critical part of the healthcare safety net isn’t jeopardized,” comments Tobey. “Once you open the door for states to waive PPS protections, if you open it even a crack, you run the risk of driving important safety-net providers out of business,” Tobey said.

The article also mentions JSI’s work with Dr. Michael Hochman at USC USC Keck School of Medicine, helping with California’s attempts to move community health centers to an alternative payment model.

While highlighting the emerging approaches, the article ends on an unsure note: “As community health centers grow and expand and potentially build collaborations with hospitals, it’s unclear how they will fit into a broader landscape that is in the midst of a consolidation frenzy,” Susannah Luthi writes.

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