LGBTQIA+ Health Education Center
Health Disparities Among LGBTQ Youth
Healthy People 2030
GMLA: Health Professionals Advancing LGBTQ Equality
The National Coalition for LGBTQ Health
A patient-centered approach to care management. Schedule a one-on-one strategy session.
[/vc_column_text][/vc_column][vc_column width="1/3"][ut_animated_image size="large" image="4047"][vc_column_text]Request a FREE custom report detailing potential outcomes of BHI, CCM, RPM, and other care coordination models. Gauge their impact on your center's quality and reimbursement.
[/vc_column_text][wpforms id="3881" title="false" description="false"][/vc_column][/vc_row]For Federally Qualified Health Centers (FQHCs), the Annual Wellness Visit (AWV) isn’t just another preventive service—it’s a powerful catalyst for improving patient care, driving revenue growth, and strengthening readiness for value-based care models.
Here’s why AWVs deserve a top spot in your FQHC’s strategy, and how you can harness their full potential.
Why AWVs Matter
AWVs offer Medicare patients a comprehensive annual check-up focused on prevention, chronic disease management, and health goal-setting. For FQHCs, they provide a structured opportunity to:
Identify Care Gaps – AWVs include health risk assessments, screenings, and a personalized prevention plan, enabling early identification of chronic conditions and social needs.
Engage High-Risk Patients – The AWV visit opens the door to enrolling eligible patients in Chronic Care Management (CCM), Behavioral Health Integration (BHI), or Remote Patient Monitoring (RPM) programs.
Enhance Revenue Streams – AWVs are reimbursed at rates of approximately $175 per visit, and coupling them with CCM or RPM can significantly increase per-patient revenue.
Align with Value-Based Care – AWVs improve quality metrics, patient engagement, and documentation—key pillars for success in value-based contracts with Medicaid, Medicare Advantage, and commercial payers.
The Potential Impact for FQHCs
FQHCs serving 1,000 Medicare patients annually could see a transformative financial and clinical impact:
Annual Revenue Impact per 1000 Patients (Example):
| Revenue Source | Estimated Annual Revenue |
|---|---|
| AWV | $175,000 |
| CCM | $223,200 |
| RPM | $72,000 |
| Total | $470,200 |
Sources of Numbers in the Model
AWV Reimbursement Rate ($175)- This is based on the Medicare reimbursement for an Annual Wellness Visit (HCPCS G0438 for the initial AWV and G0439 for subsequent AWVs). Rates can range from $150 to $200+ depending on geographic location and specific payer contracts.
- A conservative estimate based on industry benchmarks suggests that 20-40% of eligible Medicare patients seen for an AWV may qualify for and enroll in Chronic Care Management (CCM), especially when proactive outreach is used.
- This represents the national average for CPT 99490 (CCM), which pays around $62 per month per patient. Higher complexity codes (e.g., CPT 99487) can bring in higher payments.
- This assumes that 10% of AWV patients may qualify for and enroll in Remote Patient Monitoring (RPM). This aligns with adoption rates at many FQHCs, though this number can increase with proactive recruitment.
- Based on Medicare’s reimbursement for RPM codes (CPT 99453, 99454, 99457). Average monthly reimbursement is around $60 per patient when billing for both device supply and monitoring time.
Clinical Outcomes:
Improved chronic disease management
Reduced emergency department visits and hospitalizations
Enhanced patient satisfaction and trust
Strategic Benefits:
Stronger positioning in value-based care programs
Proactive management of high-risk populations
Enhanced readiness for payer negotiations and reporting
Actionable Steps FQHC Executives Can Take
Here’s how your leadership can turn AWVs into a strategic advantage:
Prioritize AWV Implementation – Establish AWVs as a core component of your care delivery strategy. Allocate staff and resources to support consistent scheduling and outreach.
Build Proactive Outreach Campaigns – Use your EHR to identify eligible patients and conduct personalized outreach to schedule AWVs. Leverage trusted messengers like care managers or community health workers.
Streamline Pre-Visit Preparation – Gather updated medical histories, medication lists, and social needs assessments before visits to maximize the AWV’s value.
Integrate Care Management Enrollment – Use the AWV as a launching point for CCM, RPM, or BHI enrollment—train providers to identify eligible patients and discuss these services during the visit.
Monitor, Measure, and Optimize—Track AWV completion rates, enrollment in care management programs, and patient outcomes. Use the data to refine workflows, staff training, and patient engagement strategies.
Final Thought
For FQHCs, the Annual Wellness Visit isn’t just a checkmark on a to-do list; it’s a strategic lever for improving patient health, increasing revenue, and demonstrating leadership in value-based care. By investing in AWVs and pairing them with proactive care management, your health center can unlock new opportunities for growth, impact, and mission.
Annual Wellness Visits are just one way we help health centers drive quality. Schedule a one-on-one strategy session to learn more.
[/vc_column_text][/vc_column][vc_column width="1/3"][ut_animated_image size="medium" image="3901"][vc_column_text]Enhance care between provider visits. Schedule a strategy session and care management impact assessment.
[/vc_column_text][wpforms id="3973" title="false" description="false"][/vc_column][/vc_row]Federally Qualified Health Centers (FQHCs) are entering a new era of value-based care. Two key changes are at the heart of this shift: the emergence of Advanced Primary Care Management (APCM) and the sunsetting of HCPCS code G0511 for care management services. As we move forward, FQHC leaders must be ready to adapt to and capitalize on these changes.
What is APCM?
APCM is a care delivery and payment model designed to align FQHC operations with the goals of comprehensive, coordinated, and value-driven healthcare. By focusing on holistic patient management, APCM promotes improved outcomes, better patient engagement, and sustainable financial models for health centers.
Under APCM, FQHCs are incentivized to deliver high-quality, proactive care through:
Patient-centered medical home (PCMH) principles
Enhanced care management and coordination
Performance-based payments tied to quality and outcomes
The End of G0511 – What’s Changing?
For years, FQHCs have used HCPCS code G0511 to bill for General Care Management services, including Chronic Care Management (CCM) and Behavioral Health Integration (BHI). G0511 provided a flat rate to cover a range of care management services, simplifying billing but sometimes limiting flexibility and precision.
Starting in July 2025, CMS will officially sunset G0511, replacing it with a requirement to report individual CPT and HCPCS codes for care management services. This change aims to:
Increase transparency by capturing the specific types of services delivered
Enable more accurate payment based on the scope and intensity of care
Encourage alignment with value-based payment models, particularly under APCM frameworks
Why This Matters for FQHC Leaders
These changes represent both a challenge and an opportunity:
Operational Readiness – FQHCs must prepare their billing, coding, and clinical documentation systems to accommodate individual codes for CCM and BHI services. Staff training and workflow redesign will be crucial.
Financial Optimization – While G0511 offered simplicity, the new structure allows for more granular billing, potentially increasing reimbursement if services are coded correctly and fully captured.
Strategic Alignment – APCM's focus on proactive, coordinated care aligns with the shift away from bundled codes like G0511. FQHCs that embrace APCM will be better positioned for success in a value-based care environment.
Action Steps for FQHC Leaders
Here’s how your health center can stay ahead:
Assess Current Workflows: Identify gaps in your current care management coding and documentation processes.
Educate Your Teams: Ensure that care managers, billing staff, and providers understand the specific codes replacing G0511 and how to apply them correctly.
Leverage Technology: Update EHR and billing systems to support accurate, real-time reporting of care management services.
Explore APCM Participation: Consider how adopting or enhancing APCM can align your FQHC with future payment models and patient care expectations.
Monitor Financial Impact: Track changes in reimbursement and adjust strategies to maintain or increase revenue while improving patient outcomes.
Looking Ahead
The sunsetting of G0511 is not merely a regulatory shift – it’s a signal that FQHCs must move toward a more sophisticated, patient-centered approach to care management. APCM provides a roadmap for achieving this goal while maintaining financial stability.
As a leader, your proactive engagement with these changes will set the stage for your health center’s success in the evolving healthcare environment.
Position your organization for the next era of value-based care. Schedule a one-on-one strategy session.
[/vc_column_text][/vc_column][vc_column width="1/3"][ut_animated_image size="large" image="4044"][vc_column_text]Request a FREE custom report detailing potential outcomes of APCM and other care coordination models. Gauge the impact on your center's quality & reimbursement.
[/vc_column_text][wpforms id="3881" title="false" description="false"][/vc_column][/vc_row]Pizza with Purpose Raffle
Book a mini strategy session at CPCA Financial.
Learn how we help FQHCs navigate value-based care and enter to win a pizza party for your team!!
[/vc_column_text][ut_animated_image size="custom" image="4040" custom_width="500" custom_height="525" effect="bounceIn" css=".vc_custom_1746473988764{border-bottom-width: -25px !important;}"][/vc_column][vc_column width="1/2"][wpforms id="4032" title="false" description="false"][/vc_column][/vc_row][vc_row css=".vc_custom_1746214775278{border-top-width: -50px !important;}"][vc_column width="1/3"][vc_column_text]Brought to you with our partners at Gojji
[/vc_column_text][ut_animated_image link_type="custom" image="4039" link="url:https%3A%2F%2Fwww.gojji.com%2Fmedicare%2F|||" css=".vc_custom_1746214821642{padding-top: -30px !important;}"][/vc_column][vc_column width="1/3"][/vc_column][vc_column width="1/3"][/vc_column][/vc_row]RSVP to save your space.
[/vc_column_text][wpforms id="4022" title="false" description="false"][ut_fancy_image image="3901"][/ut_fancy_image][/vc_column][vc_column width="1/2"][vc_empty_space][vc_column_text]Why the 2025 Final Rule matters.
[/vc_column_text][vc_column_text]More than a technical update, the 2025 Final Rule reflects CMS’s broader strategy to shift rural and community healthcare providers from volume to value. Recent updates to care management codes and the introduction of APCM represent a historic opportunity for health centers to lay the groundwork for enhanced patient care, improved operational efficiency, and increased financial sustainability. Join us for a focused session on what’s changing, what it means for your organization, and how to make the most of these new opportunities. Whether you're already participating in managed care or considering new programs, you’ll leave with strategies and tactics for the second half of 2025 and beyond. What’s covered:- 2025 Rule: Updates and big-picture impact.
- New Opportunities: Positioning your organization for success.
- Operational Alignment: Meeting care coordination, reporting, and compliance standards.
- Advanced Primary Care Management (APCM): Model impact.
- Updates on Remote Physiologic Monitoring (RPM): Remote Care best practices.
- Open Q&A, polls, and peer discussion.
Removing obstacles like start-up costs and staffing. Making effective remote care attainable for FQHCs.
[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_section full_width="" full_height="yes" css=".vc_custom_1739551479335{margin-top: 0px !important;border-top-width: 0px !important;padding-top: 0px !important;background-color: #e3f7ff !important;}" bklyn_section_anchor_id="services"][vc_row gap="10" content_placement="top"][vc_column width="1/2" offset="vc_col-lg-6 vc_col-md-12 vc_col-sm-12 vc_col-xs-12"][ut_animated_image size="full" image="4014"][/vc_column][vc_column width="1/2" offset="vc_col-lg-6 vc_col-md-12 vc_col-sm-12 vc_col-xs-12"][vc_column_text css=".vc_custom_1739552152076{padding-top: 20px !important;padding-bottom: 0px !important;}"]Book a demo and unlock the power of remote care.
[/vc_column_text][wpforms id="3973" title="false" description="false"][/vc_column][/vc_row][/vc_section][vc_row][vc_column][vc_column_text] [/vc_column_text][/vc_column][/vc_row]New C2C Resources
Check out the latest C2C resources helping consumers understand their coverage and the preventive services available. These resources also help partners and providers serve individuals in their community:- Telehealth: What to Know for Your Family – Learn about the types of care available through telehealth and how you and your family can use this technology for quality care. This resource was updated in September to include broader and more concise language.
- Telehealth for Providers: What You Need to Know – Discover useful information for health care providers about telehealth including how to get started, billing considerations for Medicare and Medicaid, when to use telehealth, and more. This resource was also revised in September to be more evergreen following the end of the COVID-19 PHE and conclusion of Medicaid Unwinding in most states.
- College Students Preventive Services Flyer and View Your Path to Better Student Health Poster now available in eight additional languages (Arabic, Chinese, Haitian Creole, Korean, Russian, Spanish, Ukrainian, Vietnamese) on the C2C site. Download the translations from the Get Preventive Care, Resources for Partners and Providers, and View All Resources webpages.
From December 2-6, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) marks National Influenza Vaccination Week by highlighting vaccine disparities and encouraging everyone to get their flu shot, which can reduce the risk of illness, hospitalization, and death.
The Centers for Disease Control and Prevention (CDC) estimates that flu was associated with up to 75 million illnesses, 33 million medical visits, 900,000 hospitalizations, and 100,000 deaths during the 2023-2024 flu season. While everyone 6 months and older should receive a flu shot each year, people with a higher risk of serious complications from the flu—including pregnant people and children—should especially ensure that their vaccines are up to date. Black, Hispanic, and American Indian and Alaska Native adults are consistently less likely to get a flu shot, with fewer than half receiving their flu shot in 2021-2022. Rural residents are also less likely to get their flu shot than people in urban areas.
Our Immunization and Vaccine Resources webpage has flu and vaccine information to help raise awareness this flu season. We encourage you to share these resources and the others listed below with those you serve during National Influenza Vaccination Week.
Resources
- Visit our Immunization and Vaccine Resources webpage to learn more about flu vaccines for underserved populations, including materials in additional languages.
- Review our Annual Influenza Vaccination Disparities in Medicare Beneficiaries data snapshot to learn about who should get the flu vaccine and about flu shot disparities among Medicare fee-for-service enrollees.
- Download CMS postcards available in English, Spanish, and 14 additional languages to encourage members of your community to get their flu shots.
- Review our Coverage to Care Prevention Resources to learn about the services, including vaccines, that are available at no cost to adults under most health coverage. Resources are available in 8 different languages.
- Download Rural-Urban Disparities in Health Care in Medicare to learn more about rural-urban differences in health care experiences and clinical care received nationally, including disparities in flu vaccine uptake.
- Explore the CMS flu webpage for information, videos, and resources about the flu.
- View the CMS Respiratory Virus Vaccine Partner Toolkit to stay informed about CMS, CDC, and HHS resources available regarding flu, COVID-19, and RSV.
- Visit the CDC’s Cold Versus Flu webpage for more information on differentiating between the flu and a cold.
- Visit Vaccines.gov to find vaccination locations.
- Explore the CDC’s Misconceptions About Seasonal Flu and Flu Vaccines webpage, which addresses common misconceptions about the flu and flu shot.
- Learn about the HHS Risk Less. Do More. campaign, which launched in August 2024 to inform the public about common respiratory viruses and available vaccines.
Access the Webinar Recording 2025 Final Rule: New Remote Care Models
[/vc_column_text][vc_column_text css=".vc_custom_1733158516613{padding-top: -30px !important;}"]The 2025 Medicare Physician Fee Schedule Final Rule provides additional compensation to FQHCs and RHCs providing care coordination services. Geared specifically towards Community Health Centers, this webinar covers the latest reimbursement opportunities, making remote care more accessible than ever. Our experts explain everything you need to know about the latest Remote Care Model. Learn how remote care reimbursements open doors for improved patient outcomes. Access the webinar, for info on:- FQHC PPS Market Basket
- New Remote Care Model
- Remote Patient Monitoring
- Remote Care Management
- Telehealth Reimbursement
- Payment for Preventative Services
Request a demo to learn how your center can benefit from RPM.
[/vc_column_text][wpforms id="3973" title="false" description="false"][/vc_column][/vc_row][/vc_section][vc_row][vc_column][vc_column_text] [/vc_column_text][/vc_column][/vc_row]The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) celebrates National Health Center Week (NHCW) from August 4-10. NHCW, sponsored by the National Association of Community Health Centers, honors the nearly 1,400 community health centers nationwide that provide health care services to 31 million+ patients across more than 15,000 communities each year. This year’s NHCW theme is “Powering Communities Through Caring Connections” and focuses on connecting communities with their local health centers to improve health outcomes.
Community health centers contribute significantly to addressing health disparities by providing quality care to all people despite their ability to pay. Specifically, they serve a disproportionate number of people with a low income and people from racial and ethnic minorities, including those living in rural areas and those with limited English proficiency. CMS OMH provides resources and support to CHCs to help them disseminate important health information to their patients. Through the Coverage to Care (C2C) initiative, CMS OMH connects CHCs and other providers to materials they can share with patients to help them understand their health coverage and the care options available to them. Share the resources below to help CHCs continue to provide quality care and reduce health disparities throughout NHCW and all year.
Resources
- Visit the C2C webpage to access our resources that can help providers and patients understand their health coverage and care options, such as the C2C Roadmap to Better Care, the Manage Your Chronic Condition webpage, and C2C’s prevention resources.
- Watch our C2C Community Connections Tour video to learn how the initiative meets communities where they are at, bringing resources directly to those who need them.
- Visit our Rural Health Resources webpage to access CMS and other HHS resources like the Rural Health Clinics Center and the Federally Qualified Health Centers Center that can help you provide care to rural communities.
- Review the CMS Framework for Advancing Health Care in Rural, Tribal, and Geographically Isolated Communities, which outlines how CMS is working to promote access to equitable care in rural, Tribal, and geographically isolated communities.
- Use the Mapping Medicare Disparities Tool to identify disparities between subgroups of Medicare enrollees within the communities you serve in areas like health outcomes, utilization, and spending.
- View the Health Resources & Services Administration’s (HRSA) Bureau of Primary Healthcare website to learn how your organization can become a funded health center.
- Find a health center near you using HRSA’s tool.
- Visit the National Health Center Week website to find NHCW events near you and explore related resources and activities.
Vaccines help protect people of all ages against many diseases and conditions. In August, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) is working to increase access to vaccines and encouraging those served by CMS to get their routine shots in honor of National Immunization Awareness Month. The Centers for Disease Control and Prevention (CDC) advises that everyone aged 6 months and older receive updated COVID-19 vaccines and flu shots each year. The CDC also recommends other routine vaccinations based on age.
However, fewer than 1 in 4 adults aged 19 or older received all their recommended vaccines in 2019. Minority populations have even lower vaccination rates, with only 15.9% of Black adults and 17.3% of Hispanic adults receiving routine vaccines compared to 23.7% White adults. Black (39.0%) and Hispanic (37.5%) Americans, as well as people who identify as other or multiple race (41.4%), also have lower flu vaccination coverage when compared with White (49.3%) adults. Significant disparities in access and health coverage, as well as a history of discrimination and distrust, contribute to these racial inequities in vaccination.
Disparities also exist in vaccination rates among children. In 2019, only 48.9% of Black children and 60.6% of Hispanic children between the ages of 6 months and 4 years old received their flu shot, compared to 64.1% of White children. Additionally, fewer children in rural areas received flu vaccines (51.8%) than those in urban areas (64.7%). The CMS Connecting Kids to Coverage National Campaign encourages families to enroll their children in health coverage so they can get the care and vaccines they need, especially as they go back to school.
During National Immunization Awareness Month, you can help your communities get vaccinated and stay healthy. Review and share the resources below to help those you serve learn more about recommended vaccines and how to access them.
Resources
- Immunization and Vaccine Resources
- Coverage to Care Prevention Resources
- Annual Influenza Vaccination Disparities in Medicare Beneficiaries
- Flu Vaccine Partner Toolkit
- Adult Vaccine Assessment Tool
- Vaccine Information for Adults
- Vaccines for Your Children
- Adult Immunization Schedule
- Child & Adolescent Immunization Schedule
- CDC "Back-to-School" Campaign
- Connecting Kids to Coverage
- Resources to Encourage Routine Childhood Vaccinations
- Vaccines for COVID-19
[vc_row full_width=""][vc_column][vc_column_text]July 10 2024 - Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), proposed new policies in the calendar year (CY) 2025 Medicare Physician Fee Schedule (PFS). Proposed policies would increase value-based care, strengthen primary care, and expand access to behavioral and oral healthcare.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][ut_btn button_align="bklyn-btn-left" font_weight="bold" button_text="View CMS Fact Sheet" button_text_color="#ffffff"][/vc_column][/vc_row][vc_row][vc_column][ut_title_divider_2 line_height="1"][/ut_title_divider_2][vc_column_text css=".vc_custom_1721151102929{padding-bottom: -75px !important;}"]