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Strategy: Maintaining Sliding Fee Scale Access When PPS Rates Are Cut

When PPS rates drop for undocumented patient services (Oct 2026), FQHCs must decide: absorb the loss and maintain access, or restrict services. Tactics include maximizing 340B drug pricing savings, r…

Strategy: CHW Outreach to Undocumented Communities Post-Enrollment Freeze

With new Medi-Cal enrollment frozen for undocumented adults 26-49, FQHCs must proactively communicate that doors remain open. Effective tactics: deploy bilingual CHWs to community events, partner wit…

Strategy: Communicating to Undocumented Patients That FQHC Doors Stay Open

Fear of immigration enforcement is driving undocumented patients away from healthcare — even from FQHCs. Critical communication tactics: (1) Post multilingual signage stating FQHC does not collect or…

Strategy: Build ECM Caseload Now Before Dec 2026 Waiver Expiration — Window Is Closing

With CalAIM's 1115 waiver expiring Dec 2026 and a hostile federal environment for SDOH-focused Medicaid programs, FQHCs must maximize ECM enrollment now. Revenue strategy: (1) Screen every Medi-Cal p…

Strategy: Revenue Diversification — 340B, Grant Stacking, and MCO Contract Negotiation

With PPS revenue under threat, FQHC leaders should diversify aggressively. Key levers: (1) Maximize 340B drug pricing savings — contract pharmacy arrangements can generate $500K-$2M annually. (2) Sta…

Strategy: FQHC Copay Exemption as Competitive Advantage — Patient Acquisition

H.R. 1 allows states to impose $35 Medicaid copays — but FQHCs are statutorily exempt. This is a major competitive advantage. Action items for FQHC leaders: (1) Add 'No Copay' messaging to all patien…

Strategy: 340B Rebate Model Pilot Launched Jan 2026 — FQHCs Must Adapt Pharmacy Workflows

HRSA's first-ever 340B rebate model pilot launched January 1, 2026 with 8 manufacturers and 10 drugs (Eliquis, Enbrel, Jardiance, Stelara). Instead of upfront discounts, FQHCs must buy at wholesale a…

Strategy: HSA-Compatible DPC Opens New Revenue Channel for FQHCs Starting Jan 2026

H.R. 1 (OBBBA) made Direct Primary Care (DPC) memberships HSA-eligible starting January 1, 2026 — up to $150/mo individual, $300/mo family. For FQHCs: this creates a subscription revenue stream from …

Strategy: Integrating ECM Revenue into Ryan White Programs — A Sustainability Playbook for FQHCs

FQHCs with Ryan White funding can layer CalAIM Enhanced Care Management (ECM) revenue on top of existing HIV/AIDS grants — but with a critical exclusion: members enrolled in the HIV/AIDS HCBS Waiver …

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, rep…