An inner-city community center has existed in your city for several decades to serve the local urban community. The center has provided varied social services to the community and offered a meeting place for the community members. Twenty years ago the center added a comprehensive health center that was approved and funded as a Federally Qualified Health Center (FQHC) by the Health Resources and Services Administration (HRSA). The FQHC has been providing comprehensive dental services for the last 10 years. However, a staff pediatrician at the FQHC has noted that she is unable to get dental appointments for her patients who have obvious dental caries. Dental services are primarily adult focused, with less than 7% of dental patients in the pediatric age range. Concerned about this problem of limited pediatric dental service availability, the pediatrician collaborated with colleagues to develop a proposal for presentation to the governing board of the health center to expand pediatric oral health services to include screening and risk assessment followed by preventive services, oral examination, and necessary dental treatment. The board accepted the proposal and appointed a committee to explore solutions and develop a grant proposal for increased HRSA funding to accomplish this goal.
-Which of the following is the most likely source of payment for oral healthcare services delivered to the children served by this FQHC dental clinic?

Question

Quizplus · Accepted Answer

By definition, an FQHC serves an underserved vulnerable population and provides care at a reduced cost on a sliding scale to increase access to care. Children from low-income families are most likely to qualify for Medicaid and CHIP. Income eligibility requirements are more stringent for Medicaid; children can qualify for CHIP with slightly higher family income. The Affordable Care Act passed in 2010 expanded availability of Medicaid to increase access to oral health care for this population. Reciprocally, this population is least likely to have private dental insurance and cannot afford to pay for dental care out of pocket. HRSA is the federal agency that funds the FQHC, but it does not directly pay for services. The center receives payment for services from the third-party provider (e.g., Medicaid or CHIP) by filing for reimbursement after the services have been provided.

An Inner-City Community Center Has Existed in Your City for Several