The Affordable Care Act provides a requirement that Community Health Centers (FQHCs) demonstrate that they have made, and will continue to make, reasonable efforts to maintain collaborative relationships with other health care providers in their catchment areas. Specifically, the legislation lists Rural Health Clinics, low-volume hospitals, Critical Access Hospitals, Sole Community Hospitals, and Medicare Dependent Hospitals as the entities with which a Community Health Center should demonstrate a collaborative relationship.

New Access Point grant applications and Service Expansion grants for FQHCs will be judged and scored, in part, on the extent to which they demonstrate the collaboration and coordination of the delivery of healthcare services with other healthcare providers in their service area. A November 2010 Policy Assistance Letter from the Bureau of Primary Health Care provides additional information on this expectation.