Value-Based Payments Associated With Improved Quality Of Care At Federally Qualified Health Centers, 2014-23

Area of Science:

• Health Services Research
• Health Policy
• Value-Based Care

Background:

• Federal and state policies encourage Federally Qualified Health Centers (FQHCs) to adopt value-based payment (VBP) models.
• FQHCs serve underserved populations, making their transition to VBP crucial for equitable healthcare delivery.
• Limited evidence exists on VBP revenue and its impact on care quality within FQHCs.

Purpose of the Study:

• To analyze trends in VBP and capitation revenue for FQHCs from 2014-2023.
• To examine the association between VBP/capitation revenue and quality of care outcomes in FQHCs.
• To identify potential quality improvements linked to VBP participation in FQHCs.

Main Methods:

• Utilized national administrative data from all FQHCs in the United States.
• Assessed the penetration of VBP and capitation revenue as a percentage of total patient revenue.
• Examined correlations between VBP receipt and nine key quality measures for preventive and primary care.

Main Results:

• VBP and capitation revenue penetration increased between 2014-2023.
• In 2023, 51.2% of FQHCs received VBP and 34.1% received capitation, averaging 2.4% and 9.4% of patient revenue, respectively.
• Receipt of VBP was linked to higher levels in seven out of nine preventive and primary care quality measures.

Conclusions:

• VBP shows potential for improving care quality within FQHCs, particularly in preventive and primary care domains.
• Despite positive associations, challenges and barriers may still hinder FQHCs' full participation in VBP programs.
• Further research is needed to address barriers and optimize VBP strategies for FQHCs serving vulnerable populations.