National FQHC Advisory Board shapes the future of community health care

Federally Qualified Health Centers (FQHCs), which serve one in five Medicaid beneficiaries and managed care organizations (MCOs) have a shared mission of delivering trusted and effective care and meaningfully addressing the diverse and distinct needs of local communities. In recognition of this critical partnership, UnitedHealthcare formed the National FQHC Advisory Board in 2010.

Members of the National FQHC Advisory Board (Board) are thought leaders and practitioners from individual FQHCs across the country, along with state primary care associations and other national associations that work to support the health center mission. The connection and insight they have about their local community and the FQHC experience is something we could not truly understand without their direct input. The partnership with the Board also allows us to see our members and the challenges they may be facing more clearly so we can work together to create better solutions.

As such, the goals of the National FQHC Advisory Board are three-fold:

• Provide guidance and input to UnitedHealthcare Community & State policy and practice issues.
• Strengthen the conversation and collaboration between managed care and the health centers, focusing on advancing health equity, expanding access and improving health outcomes.
• Work to identify successful practices and opportunities to improve and shape the future of health care delivery at large.

Over the past year, the Board has been taking a closer look at how FQHCs and managed care can work together to advance health equity. These have included initiatives focused on maternal health and primary care for individuals with disabilities, as outlined below.

Focus area: Maternal health

Pregnant individuals in the United States experience adverse maternal and birth outcomes at rates greater than those in nearly all other developed nations. The maternal mortality rate for Black, Indigenous and People of Color (BIPOC) in 2019 was 2.5 times the rate for non-Hispanic white women and 3.5 times the rate for Hispanic women, indicating significant racial disparities.^1,2 Rates of preterm births and low birth weights have also risen in recent years and BIPOC individuals have consistently experienced higher rates of preterm births and low birth weight infants than white and Hispanic women.

About half of all births in the U.S. are covered by Medicaid, suggesting that state Medicaid programs and participating MCOs are uniquely positioned to address adverse outcomes present in the maternal health space. FQHCs are also an essential partner in improving health outcomes for pregnant individuals and infants. As the provider of health care services to over 30 million individuals, almost 50% of whom are enrolled in Medicaid, FQHCs can impact maternal care under Medicaid to an extent few other entities can.³

The Board is looking at the health of mothers and babies from preconception all the way through postpartum and infant care. One outcome was to create a policy brief that examines ways to enhance care and provide potential policy opportunities to overcome challenges.

Focus area: Primary care for individuals with disabilities

Another area that the board is directing its efforts on is how to fully understand the challenges individuals with disabilities face when accessing primary care. Primary care can greatly improve the quality of life for individuals with all disabilities, yet the challenges this population faces when accessing this care are not fully understood.

Medicaid is the primary insurer for individuals with disabilities.^4,5 And with managed care organizations (MCOs) serving more than 75% of all Medicaid beneficiaries, a growing number of individuals with disabilities are also served by MCOs.⁶ As a result, Medicaid, in partnership with managed care, plays a particularly important role in ensuring access to primary care services for individuals with disabilities and FQHCs can serve as a common site for accessing those services for all populations.

As with maternal health, the Board underwent a process of examining the issue and developed policy briefs.

Looking ahead

This year the Board will continue with some of the work started in 2021 and publish the policy briefs related to those topics. They also plan to do some work in partnership with UnitedHealthcare Community & State's National Advisory Board to further the work started on improving primary care for individuals with disabilities.

They will also continue to look at other populations and specific focus areas where health centers and managed care can continue to work together to improve care delivery, enhance efficiencies and reduce provider administration burdens. 

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