When it comes to billing, Medicare reimbursement is a vital revenue stream for most federally qualified health centers (FQHCs). But many centers are missing out on the additional revenue they’re owed for Medicare Advantage patients.
This is a growing concern for FQHCs as an increasing number of patients are choosing Medicare Advantage plans. Over the years, most Medicare beneficiaries opted for traditional Medicare plans, but a growing percentage of patients are enrolling in Medicare Advantage plans instead. In 2022, 45 percent of Medicare beneficiaries were enrolled in Medicare Advantage plans, but this figure is anticipated to surpass 50 percent by 2025—which means federally qualified health centers could be missing out on more potential revenue every year if they don’t submit for these reimbursements.
Many FQHCs have questions about Medicare reimbursement. Here’s what FQHC leaders and billing professionals need to know about these supplemental Medicare payments: