Prince George’s task force hears shortfalls in HealthAssure program and cost pressures on FQHCs

Prince George's Cares Healthcare Task Force members heard a review of the county's HealthAssure program Tuesday and testimony from six federally qualified health centers (FQHCs) on how limited funding is leaving many visits unreimbursed and clinics absorbing significant costs.

The presentation by Prince George's County Health Officer Dr. Matt Levy and remarks from Sharon Zlewski of the Regional Primary Care Coalition and multiple FQHC leaders detailed program history, eligibility, recent budgets and utilization, and recommended follow-up steps for the work group.

The HealthAssure program, started in 2018 to help uninsured residents (those ineligible for other government assistance and living at or below 200% of the federal poverty level), grew from an initial county allocation of roughly $117,000 to larger infusions from COVID- and ARPA-related funding. Dr. Levy said FY 2024 funding was $5 million and FY 2025 funding is approximately $5.2 million, and he warned that those dollars "run out at the end of this fiscal year." He described HealthAssure as a reimbursement model in which the money is paid to FQHCs for covered visits and does not "follow the resident."

Why it matters

The task force was shown two intersecting funding gaps: the difference between HealthAssure reimbursement levels and actual FQHC operating costs, and the program's historical tendency to exhaust its annual allocation partway through the fiscal year, leaving months of care uncompensated.

Zlewski said the HealthAssure reimbursement rates understate the actual cost of services. "The average cost for primary medical care for the Prince George's County Health Centers providing care to all of their patients is $287 per visit," she told the group, adding that preventive dental averaged about $320 per visit and behavioral health about $287 per visit. FQHC speakers…