Access to Care

Hospital and FQHC Collaboration Initiative

Supported through The Leon Levine Foundation, this initiative aims to strengthen collaboration between hospitals and Federally Qualified Health Centers (FQHCs) to expand access to care, especially for underserved communities, by aligning their complementary roles in primary, preventive, specialty, and emergency services. Building on successful partnerships already operating in North Carolina, NCHF is engaging both strong existing hospital–FQHC collaborations and emerging partnerships to deepen coordination, share data, explore sustainable funding and reimbursement models, and identify the core elements that drive improved outcomes and cost savings. By studying and supporting these sites through a structured collaborative, the initiative seeks to create a replicable model that enhances care coordination, addresses non-medical drivers of health, improves quality, and ultimately strengthens the healthcare safety net statewide.

Frequently Asked Questions

What is the goal of NCHF Hospital-FQHC Collaboration?

Fragmented healthcare systems are ubiquitous and often lead to:

Gaps in care coordination between community providers and hospitals
Limited access to timely primary and specialty care
Avoidable emergency department visits and hospital readmissions
Persistent health disparities among underserved populations.

This project supports select FQHC–hospital partnerships across the state to strengthen and further advance their collaboration. Learning from this program will be shared statewide to inform and scale success.

The project will support creation of more seamless care networks by:

Enhancing and strengthening the existing partnerships between FQHCs and hospitals in North Carolina
Enhancing care coordination and referral pathways
Supporting data sharing and interoperability
Aligning care delivery with value-based and population health models
Prioritizing underserved and high-need populations.

How will the collaboration work?

In its early stages, the program will focus on five (5) targeted partnerships between hospitals and FQHCs most positioned for impact. Through their implementation assistance framework, the NCHF will support participating healthcare organizations in strengthening and evolving sustainable, patient-centered partnership models across the care continuum. These hospital-FQHC dyads will be invited to participate in a Learning and Action Network (LAN), giving them access to:

Statewide and national expertsin successful hospital-FQHC partnerships.
Knowledge of best practices to enhance data sharing (interoperability) processes between systems and providers
A resource library and virtual networking platform to support shared learning
Virtual and in-person convenings that support collaborative problem-solving
Training on care models that are community-informed, culturally responsive, and support scalable coordination of care delivery
Individualized quality improvement support from the NCHF team and external subject matter experts, as needs are identified.

In the third and fourth years of the program, participation will open to include any FQHC-hospital pairs in the state eager to implement best practices in a Learning Community, building on insights from the initial five LAN dyads. Partners will collaborate on self-selected projects designed to streamline care delivery, enhance patient outcomes, and reduce costs.

NCHF will collaborate with a research partner throughout the program to design and execute a robust evaluation framework, ensuring all implemented practices are measured for effectiveness and impact.

How will the 5 targeted partnerships for participation in the LAN be identified?

An assessment with specific criteria is currently being developed in partnership with other stakeholders, including the NCCHCA. This tool will be designed to assess a FQHC-hospital dyad’s readiness, inclusive of aspects of interoperability along with willingness to partner and work through challenges together.

What are the expected outcomes?

Improved patient outcomes and experience
Reduced emergency department utilization and readmissions
Strengthened community-based care capacity
Enhanced health equity across populations
Identification of effective, sustainable best practices which can be spread across North Carolina.

Who benefits from this initiative?