As an active member in the community health center industry for the bulk of my career, I know that FQHCs have been doing “value-based care” long before it was a known term across healthcare. By their very nature, FQHCs take on the added risk of managing the care and support services needed by our nation’s most vulnerable populations. From a financial standpoint, they often receive certain bonus payments by federal and state Medicaid programs, but those payments come with complicated management systems that yield little return on investment. FQHCs also rely heavily on grants but knowing that the shift to value based payments (VBP) is coming, now more than ever, leaders are thinking about how to get meaningful, actionable insights that turn VBP risk into revenue. When CMS started moving the entire healthcare industry away from fee-for-service payment models into pay-for-performance models, FQHCs remained largely unaffected. Besides, this is what they were created to do—manage the health and outcomes of the communities they serve. However, as the Medicaid and CHIP population has dramatically increased in recent years (88.3M individuals as of April 2022—a 26% increase over two years) and 39 states have now implemented Medicaid expansion, the commercial payers who manage these state Medicaid programs are pushing for even more financial accountability and risk for the populations FQHCs serve.