Rural Clinic Types
A medical clinic located in a rural or frontier area, but not certified — either as part of the Centers for Medicare and Medicaid Services (CMS) and Health Resources and Services Administration (HRSA) Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) programming. Non-certified clinics may apply to become RHCs or FQHCs, based on meeting organizational, operational and programming criteria. A clinic may not hold concurrent certifications; an RHC cannot simultaneously be an FQHC, and vice-versa.
The RHC program was established by Public Law 95-210, the Rural Health Clinic Service Act, in 1977 to increase primary care services for Medicaid and Medicare patients in rural communities. RHCs receive special Medicare and Medicaid rates, depending on the type of services that the clinic provides and the payer mix of the patient population. RHCs may operate as public, private, or non-profit entities. The national organizing body for RHCs is the National Association of Rural Health Clinics (NARHC).
Federally Qualified Health Centers (also called Community Health Centers) were created under Medicare in 1991 when Section 1861(aa) of the Social Security act was amended by Section 4161 of the Omnibus Budget Reconciliation Act. FQHCs are safety net providers that primarily provide outpatient services. FQHCs may be rural or urban and may be operated by a tribe. In Oregon, the organizing body for FQHCs is the Oregon Primary Care Association (OPCA).