If you work in the finance or revenue cycle department of an FQHC or RHC right now, chances are you’re doing the jobs of three people, and then you’re still being asked to do more. Budget cuts are not just forecasts anymore. They’re real. They’re happening. And if you’re staring down this year’s budget season wondering what else can go, we want to tell you something important:
You are not alone.
At BCA, we’ve been walking alongside community-based clinics for over 35 years. We’ve seen funding dry up, programs come and go, and payers tighten their belts. But we’ve never seen a year like this or what’s to come.
A Perfect Storm: Budget Cuts, Medicaid Uncertainty, and Rising Audit Risk
Let’s name what’s happening, clearly and honestly.
In 2025, the federal government enacted significant reductions to Medicaid funding. The bill includes stricter eligibility criteria, limitations on provider taxes, and efforts to “streamline” spending that will disproportionately affect clinics serving the most vulnerable populations. According to policy analyses, as many as 15 million patients could lose access to Medicaid, with rural clinics and FQHCs expected to bear the brunt of those losses.
These are not theoretical impacts.
If your clinic gets 10-50% (or more) of its funding from Medicaid, this is a direct threat to your ability to stay open. The shift in funding is forcing many clinics to make impossible decisions: cut hours, delay hiring, freeze wages, eliminate services. Meanwhile, demands on documentation, coding compliance, and credentialing timelines are only intensifying.
And just as we’re absorbing those blows, a new wave of RADV audits is arriving.
What You Need to Know About the 2025 RADV Audit Expansion
RADV, or Risk Adjustment Data Validation, audits are now underway at a pace we’ve never seen before.
CMS has committed to auditing every Medicare Advantage plan every year, a sharp escalation from previous cycles. That means more pressure on payers to justify the risk-adjusted payments they receive. But make no mistake: that scrutiny flows downstream. Clinics like yours, especially FQHCs and RHCs serving high-risk, underserved populations, are increasingly on the hook for the documentation that backs up those risk scores.
In our work with clinics, we’ve already seen payer partners asking for more detailed medical records, more clarification on coding rationale, and more frequent audits.
The stakes are high. When documentation doesn’t support risk-adjusted payments, recoupments happen. And in a year when every dollar matters, that can be the final straw for some clinics.
You’re Not Imagining It: This Year Is Different
We’ve seen lean years. We’ve helped clinics survive diagnosis coding system changes, payment model changes, value-based care transitions, and staff shortages. But this year?
This is a survival year.
And survival doesn’t mean doing everything perfectly. It means protecting what matters most: your ability to see patients and serve your community. That means knowing where the biggest revenue leaks are hiding, but also where small changes can make a big difference.
It means not trying to carry this alone.
How Clinics Are Staying Afloat Right Now
If you’re in a leadership or finance role, your instinct right now may be to cut. Delay. Freeze. Pause. And in many cases, that’s necessary.
But here’s what we’re hearing from clinics that are holding the line:
“We can’t afford not to know where we’re losing money.”
“We had to do something, there was no one left to review credentialing.”
“If we hadn’t had outside help, we wouldn’t have caught those documentation errors before the payer audit.”
Staying afloat doesn’t mean hiring more. It means doing smarter with less. And that’s where BCA’s Shared Services can help.
What BCA Offers: Support That Scales With You
We know what it’s like to try and do everything with limited time, limited staff, and a limited budget. That’s why we’ve designed our Shared Support Services to give clinics like yours immediate, actionable, experienced help, without hiring anyone new or committing to more than you can handle.
Starting at $3,500/month, our entry-level package includes the essentials your clinic needs to stabilize your revenue cycle and reduce compliance risk:
- Biannual documentation and coding audits for each clinician
- One-on-one provider training tied to audit findings
- Credentialing alerts and tracking tools to avoid lapses or delays
- Denial support for up to 10 claims per month
- Quarterly policy compliance review for billing and coding procedures
- Basic monthly KPI dashboard reporting to help you spot red flags early
You’ll also have access to our expert team for workflow questions, training recommendations, and guidance on what to prioritize next.
And if your clinic grows or your needs change, our services grow with you.
Ready to Talk?
If you’re staring down budget season unsure how to keep up with credentialing, denials, training, audits, and reporting, while still serving your patients meaningfully, we’re here.
Let’s talk about what kind of support could give your team the breathing room it needs.
Book your free consultation
Choose a time that works for you
No obligation. Just an honest conversation about what might help your clinic stay afloat to keep serving your community.