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Collection · 13 articles
Community health centers are navigating the largest Medicaid changes in a generation — the December 31, 2026 triple cliff (Community Health Center Fund, CalAIM waiver, MCO tax), signed-budget State-Only/UIS PPS and dental reductions now in a July 1, 2027 planning horizon, and the SB 525 wage floor. This collection tracks what changes, when, and how to model the revenue impact.
4 of 13 articles marked current · Newest review Aug 18, 2026
Track funding, payer mix, PPS, revenue, and budget pressure signals.
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Data Report
One federal storm — the December 31, 2026 funding cliff, Medicaid work requirements, ACA-subsidy expiry, and 340B pressure — is landing on every U.S. community health center, but the response is splitting the map. A fully-sourced look at backfill-vs-retreat states, the organizational pivots that are working, and how the workforce is upskilling.
Data Report
A sourced global comparison of community-based primary care — Brazil's Family Health Strategy, Costa Rica's EBAIS, Cuba, Turkey, Iran, Thailand, Ethiopia, India, Portugal, the Netherlands, Scotland's Deep End, Ontario's CHCs, Australia's ACCHOs and Alaska's Nuka — measured against U.S. FQHCs, and what each model's design choices buy in outcomes and cost.
Policy & Strategy
Three authorities expire the night of December 31, 2026 — the ~$4.6B/yr Community Health Center Fund, California's CalAIM 1115 waiver, and the ~$4.5B/yr Medi-Cal MCO tax — and ACO REACH sunsets the same midnight. The canonical explainer: what each cliff is, what's already de-risked, what survives regardless, and a role-by-role playbook for the remaining 2026 planning window.
Policy & Strategy
Newsom signed the 2026-27 budget on June 29. SB 525 and Section 504 still matter now, while UIS/PPS clinic-payment cuts, UIS dental benefit cuts, and Prop 56 dental supplemental payment cuts are delayed to July 1, 2027.
Policy & Strategy
The signed budget turns the UIS/PPS cut from a July 2026 shock into a July 1, 2027 planning window. A CFO worksheet for building your own verified exposure model.
Policy & Strategy
California's Medi-Cal MCO tax funds the primary-care rate floor that flows into FQHC reimbursement. Read this as the pre-budget setup; later budget negotiations now drive the operating interpretation.
Policy & Strategy
FQHCs can bill APCM (G0556/57/58) as monthly Medicare care-management revenue without entering a downside-risk contract. CY2026 adds BHI add-ons G0568/69/70 and sunsets G0512/G0071. Sourced to CMS, AAFP & NACHC.
Strategy
C3's PY2024 results — $10.2M net, 8.1% savings — are the strongest proof yet that the FQHC-governed Medicare ACO model can win. What it means for California, with OCHIN.
Clinical Operations
The operational companion to the CY2026 BHI codes: the three CoCM roles, the registry, measurement-based care, and how G0568/G0569/G0570 pay for the work your team already does.
Policy Analysis
Newsom's May 14, 2026 May Revision kept every January Medi-Cal cut and stacked four new ones on top: forced FFS transition for ~2M undocumented adults, state-imposed work requirements, asset limit reinstated at $2K/$3K, Prop 56 supplemental payments eliminated. Plus the premium increase to $50/month. Full side-by-side comparison, FQHC impact by service line, and timeline through July 2027. Every claim primary-sourced.
Policy Analysis
California's CalAIM 1115 waiver expires December 31, 2026. CMS approval now expected late December — at the cliff edge. ~$1.2B/yr in ECM and Community Supports funding hangs on the outcome. Six federal headwinds, seven structural tailwinds, and four scenarios FQHC CFOs should be modeling. Most likely outcome: narrowed renewal — plan FY27 baseline accordingly.
Strategy
LA County Measure ER passed and the half-cent sales tax takes effect October 1, 2026. The question for LA-area FQHCs is no longer pass/fail; it is bridge timing, allocation, reporting, and how to use the new safety-net backfill well.
Career Resources
A February 2026 workforce snapshot on Medi-Cal funding risk for community health workers. The signed June 2026 budget later delayed major clinic-payment and dental cuts to July 1, 2027.
127 external sources cited across this collection's articles, deduped and ordered by citations.
dhcs.ca.gov
communitycarecooperative.org
dhcs.ca.gov
healthaffairs.org
nachc.org
nachc.org
sbud.senate.ca.gov
340breport.com
aledade.com
annfammed.org
aurrerahealth.com
bhw.hrsa.gov
bhw.hrsa.gov
calaim.dhcs.ca.gov
calbudgetcenter.org
calbudgetcenter.org
calmatters.org
calmatters.org
calmatters.org
ccf.georgetown.edu
chwcentral.org
cms.gov
Showing 40 of 127 — the rest are linked inside each article.
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