WSHA submitted a comment letter in response to the Health Care Authority’s proposed changes to the payment rules governing Medicaid payment to federally qualified health centers (FQHCs) and rural health clinics. In our letter, WSHA voices concerns that the proposed rule language does not enable clinics to support transformation of care delivery without taking on significant financial risk of reduced payments.
The proposed HCA changes are intended to accommodate a new alternative payment model (APM) which HCA plans to pilot with a group of interested clinics effective January 1, 2017. Goals of the new APM are to provide greater flexibility in care delivery, incorporate value based incentives for quality, and simplify what has historically been a lengthy and extremely burdensome reconciliation process.
At a September 27 rules hearing, representatives of rural health clinics and Federally Qualified Health Centers testified with concerns on the progress of the new APM and the fact many critical details still need to be determined before clinics can accurately assess the impact and benefit of the new payment model to their organizations. These details include rate setting, reconciliation, and quality measures. (Andrew Busz, firstname.lastname@example.org).