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Underserved Populations; Community Health Centers; Health Reform; Health Homes


The Benefits Improvement and Protection Act of 2000 replaced the traditional cost-based reimbursement system for federally-qualified health centers (FQHCs) with a new prospective payment system. States were also allowed to implement an alternative payment methodology (APM) as long as it did not pay less than what FQHCs would have received under PPS and the affected FQHC agreed to the APM. Although changes in payment policies were to take effect in 2001, states were slow to implement them and most only did so after one or two years. With little or no oversight by the federal government, the National Association of Community Health Centers began to monitor states' activities, and in 2003, contracted the George Washington University to conduct an annual survey on the status of the Medicaid prospective payment system (PPS).

The survey focuses on four aspects of the PPS system: 1) payment rate structure, 2) changes in the scope of services, 3) wrap-around payments and 4) perceived impacts of new payment program. No comparison with survey results from previous years are made due to varying sample of states responding.


This publication was supported by Grant/Cooperative Agreement Number U30CS00209 from the Health Resources and Services Administration, Bureau of Primary Health Care (HRSA/BPHC).

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