Prince George's County Health Assures payments delayed; FQHCs report layoffs, hospitals and clinics discuss closer coordination

Prince George's County health and provider stakeholders on a work group call discussed delayed payments and program uncertainty for the county's Health Assures program, with county budget staff saying roughly $2.7 million remained to be loaded through a general fund supplemental appropriation and clinic leaders describing staff reductions and service risks.

Members of the county's Health Assures work group said the delays have forced some federally qualified health centers (FQHCs) to cut staff and scale back services even as they continue to deliver care to uninsured residents. Office of Management and Budget staff said the remaining funds are tied to a supplemental appropriation that will go before the County Council.

Why it matters: The Health Assures program subsidizes care for uninsured county residents by paying FQHCs for visits. With payments late and FY'26 funding uncertain, clinics said they face immediate cash-flow and staffing pressures that could reduce access to primary care and increase avoidable emergency-department visits.

At the meeting, Sharon (CCI) summarized the impact on her organization: "the consequences are reductions in staff workforce because we've already had to start doing it. We've we've already, last week, reduced our workforce, to make ourselves a little more lean, and able to weather what has become ... significant delays in getting the money." She told the group that CCI had hired clinicians to serve uninsured patients when the program ramped up and that the center had recently eliminated two nutritionist positions because reimbursement could not sustain them. Sharon said CCI's annual budget is about $56,000,000 and provided state-validated per-visit cost figures: $320.13 for a medical visit and $408.48 for a dental visit.

Dr. Paul Davis of Mary's Center described payer mixes at his sites: "In 2024, about 36% is self-pay and 58% is Maryland Medicaid or MCO," he said, adding that revenue at his Prince George's County location is heavily dependent on Medicaid-managed-care reimbursement.

Several FQHC speakers said Medicaid and state contract reductions would be particularly harmful. Sharon said Medicaid accounts for roughly half of CCI's revenue (she estimated about 50'56 percent), Medicare is under 5 percent, private insurance about 8 percent and uninsured roughly 39 percent; exact, unduplicated-client counts and final tables were said to be supplied to the work group later the same day.

Hospital representatives described varying degrees of coordination with FQHCs. A Capital Region representative said the system does not currently include FQHC follow-up referrals in emergency-department discharge folders but was "open to beginning to do that," and said a transitional-care program schedules follow-ups for discharged inpatients and can refer patients to either FQHCs or the hospital's medical group depending on geography. That representative also recounted a case in which hospital specialists treated a prenatal patient referred from an FQHC and provided surgery and oncology care at no cost through the hospital system's financial-assistance program.

Work group members and clinic leaders discussed practical collaboration measures hospitals and clinics could pursue, including joint grants, shared continuing-education programs, recruitment partnerships for medical assistants and integrating referral workflows and data sharing to smooth transitions from hospital to primary care.

On the county budget side, Tara Bynum of the Office of Management and Budget told the group: "The 2,700,000.0 that we're waiting to be loaded is within the next general fund supplemental appropriation." She said the supplemental appropriation would go before the County Council soon and that the county had been trying to identify interim means of getting funds out pending that action. Work group members also heard that the county budget would be publicly released the following day.

The group identified several follow-ups: (1) outstanding written data from several FQHCs on payer mix, site counts and invoices (some responses were pending and one FQHC said its CFO would finalize numbers that afternoon); (2) hospital outreach to expand discharge referrals to FQHCs; and (3) OMB attendance at the next meeting to review the Health Assures budget status and any FY'26 funding decisions. No formal votes were taken during the meeting.

The work group scheduled further review of written responses from FQHCs, hospitals and CASA (for immigrant-health needs) and asked that missing documentation be provided so that the group can complete recommendations on program administration and contingency planning for reduced funding.