Using value-based care to strengthen partnerships between FQHCs and Community-Based Organizations (CBOs)

By Janel Sia, COO and Co-Founder of Yuvo Health

There’s a very good reason that Federally Qualified Health Centers (FQHCs) are also known as community health centers. They are the glue that holds neighborhoods together, providing necessary care to underserved people from all backgrounds and circumstances.

Many of the people who rely on FQHCs are new to the United States and may be hesitant or unable to access services for living safe and healthy lives in their adoptive country. In addition to the challenges of finding housing, employment, and education, many migrants, refugees, asylum seekers, and immigrants face a huge amount of culture shock that can have a profound impact on their health.

I know how disorienting it can be to build a new life in an unfamiliar place. My childhood was split between growing up in various family households in the Philippines and living in Westchester, NY, where my mother was recruited to work as a nurse. Moving to America brought a number of jarring cultural experiences that shaped my outlook on my new community, and I was one of the fortunate ones with a supportive family, the opportunity to get a college education, and access to high-quality healthcare.

The majority of people coming to the United States aren’t so lucky. Economic opportunities for newly arrived people can be limited, making it difficult to find affordable and accessible primary care and stigma-free mental health care – unless they have a local FQHC.

FQHCs are lifelines for newly arrived individuals and established residents alike. Together with partners across the community, they form the central pillar of a holistic, person-centered ecosystem that enables millions of vulnerable people to navigate their challenging lives.

Community-based organizations (CBOs) such as food pantries, housing and transportation services, and legal aid, are critical to FQHCs’ success. CBOs fill in the gaps for underserved populations so they can stay safe and healthy. When I talk to FQHCs, they always mention the importance of CBOs for providing meaningful care. And they always lament their lack of capacity to build more formalized, robust relationships with community organizations.

We can change that. Through innovative reimbursement models that create financial sustainability and relieve administrative pressures, we can give FQHCs extra bandwidth to bulk up their investments in CBO partnerships and provide even more comprehensive care for more people in need.

Forging stronger relationships with community-based colleagues

Currently, many relationships between FQHCs and CBOs are relatively informal. Sometimes, a nurse calls her friend at a local CBO and convinces her to squeeze in a patient or two. Other times, it’s just a matter of getting lucky with whoever is answering the phone that day. This system may be workable with only a few patients now and again. But the reality is that many, many FQHC patients need emergency food supplies, or help with housing stability, or shelter from an abusive situation.

In an ideal world, an FQHC would be able to send out a referral to a CBO, have that referral acknowledged, and quickly receive information about whether or not the CBO will be able to provide that service. If not, the FQHC could reach out to a different organization and go through the same process until they find the right care for their patient.

This would require FQHCs to have information exchange connections and service arrangements with a relatively large number of CBOs. While this goal might seem out of reach at the moment, the vision is becoming more of a reality as technology advances and reimbursement align to make formal relationships possible.

How value-based care opens new doors for effective community partnerships

For FQHCs like yours, value-based care represents a bridge to financial sustainability. By tying a greater proportion of reimbursements to care quality and patient outcomes, you can capitalize on the phenomenal clinical services you already provide. Doing so will allow more community health centers to escape the rat race of chasing after grant funding and constantly worrying about whether the money will come through.

With a more stable revenue environment, along with the opportunity to earn enhanced incentives and quality bonuses, you can stop worrying so much about keeping the lights on. Instead, you can start to explore practice transformation efforts that will set yourself up for even greater success in the future.

With more time on your hands, you can begin looking at your data more closely, understanding your populations better. And you can reach out to CBOs in your catchment area that specifically address those needs.

It might sound too good to be true, but it doesn’t have to be. With the right partner, FQHCs can gain access to critical complementary services that relieve pressure on finite resources and make it possible to dive deeper into holistic, proactive care.

As an independent practice association (IPA), Yuvo Health provides administrative services, access to contracts, and strategic support so you can use your scarce internal resources for tasks like expanding clinical and non-clinical services for high-needs populations.

Working in concert with other independent FQHCs also enables community health leaders to learn from their peers, leverage their colleagues’ relationships with key CBOs, and increase collective bargaining power with health plans and other entities.

Looking toward a future of financial and clinical sustainability

There’s no question that FQHCs have been burned over and over again by people promising them resources or offering a technology to solve their biggest problems. It’s difficult to parse through dozens of pitches from ambitious organizations looking to make moves in a growing sector. IPAs are different, however. Members become true partners, not customers, and fully retain the ability to run their clinics and make advantageous decisions for themselves.

To belabor a metaphor a little, we’re not here to give FQHCs a fish and claim it will feed them for a lifetime. Our job is to take over some of the more tedious fishing-related background tasks so FQHCs can focus on what’s important: serving up high-quality healthcare to a hungry community.

Much like migrants searching for new opportunities in an unfamiliar community, FQHCs simply need to remain open to the possibility that value-based care can turn a rocky past into a promising future.

By choosing partners with a shared focus on prioritizing patient care for vulnerable populations, FQHCs can deepen their roots in their communities, address the unique needs of their diverse patients, and continue to offer top-quality care to everyone who comes through their doors.