Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities. 2. Federally Qualified Health Centers


FQHCs are community-based providers of comprehensive primary care, serving medically underserved communities and vulnerable populations. FQHCs operate in many high-need, underserved communities across the country but do not always focus services on people who are homeless. FQHC services are less likely to be available in rural than in urban communities.

FQHCs are CHCs (Health Centers) and HCH programs that receive grants from HHS’s Health Resources and Services Administration (HRSA). They receive Medicaid reimbursement for covered services provided to eligible people. In addition to Health Centers and HCHs, a small number of similar providers qualify for Medicaid’s FQHC reimbursement under “look-alike” provisions. In this paper we refer to all of these organizations as FQHCs or Health Centers. Some Health Centers also receive grants from HRSA to operate Public Housing Primary Care (PHPC) programs that serve residents of public housing and other U.S. Department of Housing and Urban Development (HUD)-assisted housing.

The rates at which FQHCs receive Medicaid reimbursement are calculated under a payment mechanism specific to FQHCs and usually are significantly higher than Medicaid rates paid to other health care providers for ostensibly similar services.13 FQHC rates are based on a calculation that divides the Health Center’s total reasonable costs for delivering health services by the total number of patient encounters. Medicaid reimbursement is provided to FQHCs only for face to face encounters between specified types of providers and patients who are enrolled in Medicaid.

FQHCs are able to provide services to PSH residents regardless of whether the person is enrolled in Medicaid or has a particular diagnosis or type of disability because, in addition to Medicaid reimbursement, most FQHCs also receive federal grant funding administered by HRSA. This grant funding, often combined with other funding sources, allows Health Centers to provide care to people who do not have insurance coverage through Medicaid or any other source. Health Centers generally use a sliding fee scale, with patient fees adjusted based on income. For homeless people with or without Medicaid, there usually is little or no charge to the patient for care provided by the FQHCs.

View full report


"ChrHomls2.pdf" (pdf, 1.47Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®