What is a Federally Qualified Health Center?

ABOUT F.Q.H.C.s

By Dr. David E. Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

I worked at several FQHCs as a medical student and intern, back in the day, both in urban and suburban settings. But, I never was sure what this entity was, exactly. Probably because I was from an under served area, myself.

DEFINITION:

A Federally Qualified Health Center (FQHC) is a reimbursement designation from the Bureau of Primary Health Care and the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services. This designation is significant for several health programs funded under the Health Center Consolidation Act (Section 330 of the Public Health Service Act).

It is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status.

Thus, they are a critical component of the health care safety net. FQHCs are called Community/Migrant Health Centers (C/MHC), Community Health Centers (CHC), and 330 Funded Clinics. FQHCs are automatically designated as health professional shortage facilities.

CMS: https://www.cms.gov/Center/Provider-Type/Federally-Qualified-Health-Centers-FQHC-Center

FQHC.org: https://www.fqhc.org/what-is-an-fqhc/

Your thoughts are appreciated.

ORDER: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

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PODCAST: Social Determinants of Health

Turning Potential into Actual Value

By Erin Benson and Rich Morino

Social determinants of health can directly be used to improve risk stratification and care management initiatives. But first, it’s important to identify how to effectively use this data to get the most value for your members and organizations.

And so, we present a brief recap of the webinar: “Social Determinants of Health: Turning Potential into Actual Value,” sponsored by LexisNexis Health Care, with Erin Benson, Director Market Planning and Rich Morino, Director, Strategic Solutions.

This recap includes discussion of 5 categories of SDOH. Then, the full webinar discusses elements of success for social determinants of health and opportunities for health plans to leverage social determinants of health data to attain quality goals while managing cost and enhancing member experience.

Your thoughts are appreciated.

THANK YOU

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Physicians “FIRING” Patients?

ON TERMINATING PATIENT RELATIONSHIPS

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By Dr. David Edward Marcinko MBA CMP®

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SPONSOR: http://www.CertifiedMedicalPlanner.org

Just as it is an acceptable and reasonable practice to screen incoming patients, it is acceptable and reasonable to know when to end relationships. Termination criteria are numerous and varied. Although not exhaustive, the following are situations in which termination may be appropriate and acceptable:

  • Treatment noncompliance—The patient does not or will not follow the treatment plan.
  • Follow-up noncompliance—The patient repeatedly cancels follow-up visits or is a no-show.
  • Office policy noncompliance—The patient uses weekend on-call physicians or multiple health care practitioners to obtain refill prescriptions when office policy specifies a certain number of refills between visits.
  • Verbal abuse—The patient or a family member is rude and uses improper language with office personnel, exhibits violent behavior, makes threats of physical harm, or uses anger to jeopardize the safety and well-being of office personnel with threats of violent actions.
  • Nonpayment—The patient owes a backlog of bills and has made no effort to arrange a payment plan.

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It is an acceptable practice to end a patient relationship under most conditions. There are a few situations, however, that may require additional steps or a delay of the termination. According to The Doctors Company, Laura A. Dixon JD RN,the following circumstances fall into this category:

  • If the patient is in an acute phase of treatment, termination must be delayed until the acute phase has passed. For example, if the patient is in the immediate postoperative stage or is in the process of medical workup for diagnosis, it is not advisable to end the relationship.
  • If the practitioner is the only source of medical or dental care within a reasonable driving distance, he or she may need to continue care until other arrangements can be made.
  • When the practitioner is the only source of a particular type of specialized medical or dental care, he or she is obliged to continue this care until the patient can be safely transferred to another practitioner who is able to provide treatment and follow up.
  • If the patient is a member of a prepaid health plan, the patient cannot be discharged until the practitioner has communicated with the third-party payer to request a transfer of the patient to another practitioner.
  • A patient may not be terminated solely because he or she is diagnosed with AIDS/HIV.

When the situation with the patient is such that terminating the relationship is appropriate and acceptable and none of the restrictions mentioned above are present, termination of the patient relationship should be completed formally. The patient should be put on written notice that he or she must find another health care practitioner. The written notice should be mailed to the patient by regular and certified mail, return receipt requested. Keep copies of the letter, the original certified mail receipt, and the original certified mail return receipt (even if the patient refuses to sign for the certified letter) in the patient’s medical record.

YOUR THOUGHTS ARE APPRECIATED

ORDER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

THANK YOU

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