Understanding Different Healthcare Delivery Models: Home Health Agencies, Community Health Centers, and Rural Health Clinics
When it comes to healthcare delivery, there isn’t a one-size-fits-all approach. Depending on various factors like patient needs, location, and financial capabilities, different healthcare models are designed to offer optimal care. We recently helped a nonprofit organization navigate this decision and thought it was great information to share. In this blog post, we’ll discuss three key healthcare providers: Home Health Agencies, Community Health Centers (also known as Federally Qualified Health Centers or FQHCs), and Rural Health Clinics (RHCs).
Home Health Agencies
Home Health Agencies are tailored to meet the needs of homebound patients requiring skilled nursing services and other therapeutic services. Their primary mission is to deliver specialized short-term services under a physician’s direction. This service model is often used by individuals aged 65 and older, or those with short-term respite needs.
Home Health Agencies offer a range of licensed services such as nurse evaluations, medication management, physical therapy, occupational therapy, speech therapy, wound care, and diabetic management. However, it’s important to note that companion services are not covered by insurance and are considered “non-skilled”.
Services are usually delivered at the patient’s home, and these agencies are regulated by state health departments. A Certificate of Need (CON) may be required for these agencies to operate, depending on the state they are operating in.
Community Health Centers (CHCs/FQHCs)
Community Health Centers (CHCs), also known as Federally Qualified Health Centers (FQHCs), are nonprofit healthcare facilities that provide comprehensive, high-quality, cost-effective care. Their mission is to serve individuals with limited access to healthcare, regardless of their location (urban or rural), or their ability to pay for services.
CHCs offer a range of primary medical care services including behavioral/mental health care, dental services, diagnostic services, prescription drugs, case management, language assistance, culturally-competent and sensitive care, health education, and assistance with program applications.
These centers cater to all types of patients depending on license/provider types, and services can be delivered in the clinic, at the patient’s home, or via telehealth. CHCs are regulated by state health departments and CMS. May require a CON depending on the state and if they are already operating as a General Health Care Facility.
FQHCs also enjoy financial incentives like Federal government cash grants, cost-based reimbursements for their Medicaid patients, and malpractice coverage.
Rural Health Clinics (RHCs)
Rural Health Clinics (RHCs) are designed to deliver primary care services in rural areas. They utilize a team approach of physicians working with non-physician providers like nurse practitioners, physician assistants, and certified nurse midwives.
Services provided by RHCs include primary care and preventative services, behavioral/mental health care, lab services, some care management services, case management, and hospice attending physician services. Like CHCs, RHCs can deliver their services in clinics, at the patient’s home, or via telehealth.
RHCs can be public, nonprofit, or for-profit healthcare facilities and are regulated by state health departments and CMS. They enjoy enhanced reimbursement rates for providing Medicare and Medicaid services, a key financial incentive for these centers.
Which do you choose for your business or clinic?
Each of these healthcare providers plays a critical role in our healthcare ecosystem, providing services tailored to specific patient needs and demographics. Understanding these differences is key to making informed decisions about healthcare delivery and utilization.
If you need more information, the following links to relevant national organizations have more information on each designation:
- National Association for Home Care & Hospice (NAHC): NAHC is a resource for information and advocacy related to home care and hospice.
- National Association of Community Health Centers (NACHC): NACHC provides resources and advocacy for community health centers across the U.S.
- National Association of Rural Health Clinics (NARHC): NARHC is the national organization of Rural Health Clinics in the U.S.
- Medicare.gov: The official Medicare site provides detailed information about the services covered by Medicare, including those provided by Home Health Agencies, Community Health Centers, and Rural Health Clinics.
