Strategy: Creative Financing Playbook — 6 Revenue Streams Beyond Section 330 for the Next 3 Years

With CHCF expiring Dec 2026 and Medicaid cuts squeezing margins, FQHCs must diversify NOW. Six proven strategies: (1) 340B optimization — most FQHCs capture only 20-30% of eligible prescriptions, representing millions in missed revenue. (2) DPC subscription overlay — $150/mo HSA-eligible (new Jan 2026). (3) ECM/Community Supports PMPM layering on top of grant-funded programs. (4) Employer direct contracts — map community employers, offer workplace health services. (5) Value-based APMs with per-member-per-month payments (PPS rules allow FQHC payment under APMs if revenue ≥ PPS equivalent). (6) Revenue cycle tightening — A/R below 45 days, denial management, annual payer contract reviews. A 3-5% improvement in collections = hundreds of thousands annually.