FQHC Operations Intelligence
Analysis and insight on 340B programs, pharmacy operations, Medicaid coverage, and FQHC transformation.
Your EMR Vendor Is Not Coming to Save You
Every FQHC leadership team has the same plan for H.R.1. “We’re going to wait and see what our EHR vendor offers.” Here is what you need to understand before December 31, 2026 arrives.
The 90-Day Safety Net Is Gone: What the 30-Day Retro Eligibility Window Means for FQHCs
Retroactive Medicaid eligibility coverage shrank from 90 days to 30. For FQHCs, that means every coverage gap costs more, every delay is unrecoverable, and every workflow must move faster.
Medicaid Work Requirements Are Coming: What FQHCs Need to Do Before January 2027
HR 1 mandates 80 hours of community engagement for Medicaid expansion adults starting January 2027. Arkansas lost 18,000 enrollees. Nebraska is already seeing the churn. Here is what Maryland FQHCs should be doing right now.
The 340B Rebate Model Is a Solution to a Data Problem. It Is the Wrong Solution.
HRSA's 340B Rebate Model Pilot launches January 1, 2027. The rebate model shifts cash flow risk to covered entities without resolving the underlying data disagreement. A neutral clearinghouse already exists — and it is the right answer.
FQHCs Are Modeling the Wrong Number on Medicaid Work Requirements
FQHCs are building compliance budgets for Medicaid work requirements. The number that matters is the revenue impact of patient loss — and most organizations have not modeled it.
The HIV Patient Value Calculation Most FQHCs Are Getting Wrong
FQHCs calculate HIV patient value by prescription revenue. The correct number includes 340B capture, retained patient lifetime value, and a board argument most organizations have never made.
Insurers Are Using AI to Deny Care. Health Systems Are Still Using Spreadsheets to Measure the Damage.
Insurers have deployed AI at scale in utilization review. Health systems are absorbing the impact without the data infrastructure to measure it. Maryland’s public workgroup record shows how large this gap has become.
Maryland Has the Data Infrastructure. Your FQHC Needs the Workflow That Uses It.
Medicaid Redetermination Is Not a Payer Problem � It Is an Operational Workflow You Need to Own
The Shifting Landscape: How the Inflation Reduction Act Impacts 340B Covered Entities
Comprehensive analysis of how the Inflation Reduction Act''s drug pricing reforms intersect with the 340B program, examining duplicate discounts, rebate models, and financial implications for covered entities.
From Reactive to Predictive: How Coverage Monitoring Changes FQHC Operations
Most FQHCs discover coverage loss when claims deny. By then the revenue is gone. Predictive coverage monitoring flips the model — catching gaps before they become write-offs.
Why Your Board Does Not Understand Your Pharmacy Program (And How to Fix It)
Most FQHC boards see pharmacy as a cost center. The problem is not their intelligence — it is how you are presenting the data. Here is how to translate pharmacy operations into board language.
Specialty Patients and Coverage Gaps: Where the Biggest 340B Losses Hide
A single specialty patient who loses Medicaid coverage can cost your 340B program $40,000 per year. Most FQHCs have no system to catch this before it happens.
Five EHR Reports Every FQHC CEO Should Run Before October
Most FQHC leaders see their EHR as a clinical tool. It is also an early warning system — if you know which reports to pull. Here are five that will change how you run your health center.
The Hidden Cost of Coverage Churn: Why Your FQHC Is Losing Revenue It Never Sees
Every month, patients silently lose Medicaid coverage. Your FQHC absorbs the cost through sliding fee and write-offs. Here is how to quantify the bleed and stop it.
Medicaid Managed Care and 340B: The Carve-In Trap Nobody Talks About
If your state uses Medicaid managed care carve-in for 340B, your duplicate discount exposure is real. Here is what a clean reconciliation process looks like.
Stop Treating 340B Like a Revenue Line: It Is an Operational Program
340B is not a revenue line that shows up automatically. It is an operational program that requires active management. Here is what most organizations get wrong.
Building a Specialty Pharmacy Program Inside Your FQHC: A Practical Guide
Specialty pharmacy is where the largest 340B savings live, yet most FQHCs send these prescriptions to external pharmacies. Here is a practical path from zero to operational.
HRSA Site Visits Are Changing: What the New Audit Protocol Means for You
HRSA updated its 340B audit protocol in 2026 — larger sample sizes, deeper contract pharmacy reviews, and a shorter corrective action window. Here is what changed.
Contract Pharmacy in 2026: The Manufacturer Restrictions Are Not Going Away
Manufacturer restrictions on contract pharmacies are expanding, not reversing. Here is how to restructure your 340B program for the reality of 2026.
FQHC Workforce Crisis: Five Operational Fixes That Do Not Require New Hires
The labor market is brutal, but most FQHCs have more capacity than they realize. Here are five operational fixes that free up hours without adding headcount.
The MFP Era Is Here: What the First Negotiated Drug Prices Mean for Your 340B Program
The first Medicare-negotiated drug prices are live. Here is what they actually mean for your 340B savings, your compliance obligations, and your financial projections.
Navigating 340B Compliance: Essential Guidelines for July 2025
The organizations that pass HRSA audits without breaking a sweat are not the ones with the thickest policy binders. They are the ones where compliance is embedded in how the pharmacy actually runs.
340B Program Updates for July 2025: Key Changes FQHCs Need to Know
HRSA shortened the recertification window, tightened contract pharmacy oversight, and more manufacturers imposed restrictions. Here is what changed in Q3 2025 and what to do about it.
Pharmacy Operations Excellence: July 2025 Best Practices
The gap between a pharmacy that runs well and one that just gets by is rarely about staffing or technology. It is almost always about how the work is organized.
Client Success Story: How We Helped Increase 340B Revenue by 35%
A multi-site FQHC was leaving $1.1 million in 340B savings on the table. The fix was not new software. It was understanding where the data flow broke down and fixing the handoffs.