Free and charitable clinics and networks are not-for-profit, community-based and faith-based organizations

They provide healthcare services at little or no charge to low-income, uninsured and underserved individuals, while relying heavily on volunteer healthcare professionals and community partnerships. Florida has more than 100 free and charitable clinics and networks, most of any state.

The Florida Association of Free and Charitable Clinics (FAFCC), a not-for-profit 501c3 organization currently headquartered in Miami, represents and supports Florida’s free and charitable clinics and networks through public policy advocacy, funding and resource development, knowledge exchange, data collection and research, and marketing.

Even with the Affordable Care Act (Obamacare) in place free and charitable clinics continue to play a critical part of the healthcare safety net. Currently, Florida has chosen to not expand its Medicaid program (or implement an alternative), but in the event the state chose to move forward a study by the Urban Institute indicated there would still be approximately 1.7 million uninsured residents.

The numbers included in the FAFCC’s first ever valuation report (view below) reflects care provided from 90+ member clinics across the state of Florida from July 1, 2018 – June 30, 2019.

2018-2019 Valuation Totals and Methodology

The numbers below reflect FAFCC’s first ever valuation report. The value reflects care provided from 90+ member clinics across the state of Florida from July 1, 2018 – June 30, 2019.

Below the totals provided, is the methodology that was created to calculate each category.

Regional Breakdown of Total Value of Care

Method on Providing Valuation for Visits

Each clinic was assigned a flat valuation rate for each visit that corresponds with the reimbursement rate received by the closest Federally Qualified Health Center (FQHC) to that clinic.

The encounter rate was chosen as the best method to reflect the valuation of visits as it is a universally accepted measurement of valuation and is the same rate used for Medical, Vision, Dental, Mental Health, and Wellness visits Pairing each clinic with the closest FQHC in proximity was chosen as the best approach to determine the best-reflected encounter rate, as both locations being in relative proximity with one another are likely to see similar visits at similar rates.

For visits outside of medical that are non-routine or referred out (i.e., dental and/or vision), if the value of the procedure or visit is known, it will be noted in the specialty care/procedures question in the health care visits section.

Method on Providing Valuation for Prescription and Imaging Services

Summary

Clinics will have two options for reporting valuation of generic prescriptions and imaging services. A clinic will either report the data they have collected for all prescriptions and/or imaging services or calculate valuation data using a standard value.

Standard Value

The standard value will serve as a state-wide set value that clinics can use to calculate the valuation of prescriptions and imaging services. Generic prescriptions were used to calculate the standard value. Whereas, the standard value of Imaging Services was provided through the aggregate average of six types of imaging services. Imaging Services was divided into six categories as follows: X-rays, Mammograms, Ultrasounds, CT Scans, MRIs, and other. The types of imaging services were provided through a list of 2018 Medicare rates for various imaging studies conducted by the American College of Radiology. Lab services are not included in the standard valuation steps. Clinics can refer to their partnered labs to determine the cost of services if not already determined.

Method for Providing Valuation for Labs

Summary

Clinics who have specific value data from their partners who do the lab testing will report the sum of this value. Clinics who do not have specific value data will not report on this.

Method for Providing Valuation for Specialty/Hospital Inpatient/Outpatient Services

Summary

For clinics: Clinics will have two options for reporting the valuation of specialty care. By default, all reported specialty care visits (including dental, vision, mental health, and wellness) will be valued using the standard FQHC encounter rate, described above. For visits/services where the specialty care provider has reported the value of the service, the clinic may report the sum of the reported value of those visits/services. Clinics may use a combination of these two methods.

For specialty care referral networks: these members will report the sum total of the value of specialty care, as reported to them by the organizations that provided the service. Specialty care networks may choose to utilize the standard FQHC encounter rate for the cases where the provider has not specified a value for the service.

Method for Providing Valuation for Durable Medical Equipment (DME)

Summary

Members will report the value of DME and diabetic testing supplies. They will report the sum of values assigned by the supplier, retailer, or donor. If no value was provided, members can use the amount on the CMS fee schedule for Florida DME.