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Difference Between FQHC and RHC

FQHC vs RHC

“RHC” stands for “Rural Health Clinics” while “FQHC” is the acronym for “Federally Qualified Health Centers.” Both government programs are designed to provide medical help for people in medically-challenged areas.

The difference between RHCs and FQHCs involves many aspects. A partial mention of these differences includes location, range of services, and scope of benefits. However, the main difference is how the federal government administers both programs.

RHCs are considered the essential source of outpatient care, emergency care, and basic lab services in many rural areas. RHCs are certified by the Centers for Medicare and Medicaid Services (CMS). They provide healthcare services for the insured, uninsured, and underinsured. RHCs can be classified as provider-based (affiliated with a hospital or healthcare institution) or independent (also known as freestanding).

RHCs provide care in rural areas and places which are categorized as Health Professional Shortage Areas (HPSA) or Medically Underserved Areas (MUA). These areas must be updated every three years to qualify for their designation.

On the other hand, FQHCs are also known as Community Health Centers. These centers provide RHC care with more comprehensive services that must be made by formal arrangements. Services include; diagnostic and lab, pharmaceutical, behavioral and oral, hospital and specialty, after-hours care, case management , transportation, and interpretative services.

FQHCs provide care for people in rural and urban areas that are labeled as MUAs or Medically Underserved Populations (MUP).

Both RHCs and FQHCs use non-physician and physician providers. For RHCs, employment of these personnel is a need. Also, RHCs and FQHCs can be classified as non-profit or for-profit. But RHCs don’t have specific requirements for a Board of Directors unlike FQHCs. The FQHC Board comprises the active and registered patients of the center.

In terms of funding, RHCs do not receive federal funding for startup, support, or expansion. In the case of FQHCs, they may receive funding for financial activities like those mentioned above. RHCs are not required to provide services to anyone in the community. Meanwhile, FQHCs must provide services to all community residents. Malpractice insurance is provided by RHCs themselves while the same type of insurance is under the coverage of the Federal Tort Claims Act.

Both RHCs and FQHCs are subject to review and survey. RHCs are overseen by the CMS to maintain their certification while FQHCs are under a federal objective review every five years.

Summary:

1. Both RHCs and FQHCs are government programs that provide healthcare services in many medically-challenged areas. Both types of programs have a specific scope, location, and services.

2. RHCs (Rural Health Centers) are situated in rural areas while FQHCs (Federally Qualified Health Centers) serve both urban and rural areas. RHCs are commonly seen in HPSAs or MUAs. FQHCs serve both MUAs and Medically Underserved Populations (MUPs).

3. FQHCs provide broader healthcare services compared to RHCs. Services in FQHCs are made by appointment while RHCs only provide primary outpatient care, basic lab services, and emergency care.

4. RHCs are under the Centers for Medicare and Medicaid Services (CMS) and can be classified as provider-based or independent. Conversely, FQHCs are under a federal objective review.

5. RHCs do not use federal funding while FQHCs are eligible for federal coverage. In terms of malpractice insurance, the RHCs themselves provide for the insurance, but the FQHCs can get the money from the federal funding under the Federal Tort Claims Act.

6. The FQHCs require a Board of Directors while the RHCs do not. However, both RHCs and FQHCs can exist as for-profit or non-profit.

7. RHCs are not required to give healthcare services to the people in the community. In contrast, FQHCs are required to provide for every member under its jurisdiction.

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2 Comments

  1. Please tell me how fqhc can be for profit and what would be different from a not for profit fqhc

  2. This article is inaccurate. FQHCs cannot be for profit entities

    Also, the certification/operational audit for FQHCs is every 3 years, not 5. This audit quite comprehensive, and a major distinction from RHCs that don’t have a mandatory review to maintain their status.

    RHCs are designed basically to incentivize rural clinics to take Medicaid and Medicare patients. The clinical scope of RHCs is much larger than stated in this article, and some do specialty care, on-site lab, etc. One way to look at an RHC is it’s a special designation for an existing clinic to get a better payment structure for Medicare/Medicaid patients. FQHCs are often small health systems with multiple locations, services, and can’t turn away patients (RHCs totally can).

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