The most productive communities are those with a healthy population. That’s why Community Health centers exist: to provide the medical support our communities need to maintain good health. At a state and local level, we’ve all seen the need and the federal government acknowledged the need by creating the Community Health Center Fund in 2010 to pay for the operation and expansion of health centers through the nation. So far, they’ve appropriated close to 3.8 billion dollars. The money helps with the growth of these health centers but it doesn’t solve all their problems. Joan Quigley, President and CEO for North Hudson Community Action Corp, said “We are always struggling to keep up with funding”. The RAND research group conducted research on FQHC’s. When asked about operational viability, a researcher said “Although many federally qualified health centers have historically provided patient-centered, team-based care, the implementation of other medical-home components, such as expanding access to care after hours and developing data-analytic capabilities, may present substantial challenges in health centers that have limited financial resources or high staff turnover.”
Let’s talk about some of the operational challenges FQHCs face. I’ve created some useful tips to help FQHC’s strategically overcome growth challenges and hopefully continue to be a source of strength to our communities.
Rapid growth can cause considerable inefficiencies. Health centers juggle staffing, patients, equipment, facilities, technology and the list goes on and on. One of the most critical operational responsibilities is billing since this is the source of revenue. Billing departments have a lot of responsibilities and interruptions are constant. This can lead to inefficiencies or mismanagement.
We’ve even experienced this in our own organization. We knew we wouldn’t be able to easily scale our operation without change so we decided to implement Business Process Re engineering [BPR]. This exercise was critical for developing and scaling our early-out and collection services. BPR transformed our departmental knowledge, highlighted strengths and weaknesses within our policies and processes and brought our teams closer together through collaboration.
To get started, create a team that meets weekly. Their meeting purpose should be to identify and create billing policies and procedures that add value to your organization. Standardizing your processes and policies will make training a lot easier for your trainer and trainee and help in providing valuable services to your patients. Your managers will be able to collaborate with other managers, they’ll identify bottlenecks in their respective areas and, the best part, this will make it much easier to scale. I won’t sugar coat it though. BPR is a lot of work! You’ll want to make sure you have buy-in from all those that participate before you get started and make the meetings mandatory.
Staffing is expensive. The Society for Human Resource Management states that the average cost to hire an employee is $4,129. Sometimes, it makes more sense to automate the work or outsource the position. Typically, we’ll do this if we find the role spends a considerable amount of time performing manual processes. We did this with our Medicaid verification process. There was a time when our staff manually searched for missed Medicaid via the Medicaid website. This took a considerable amount of time so we created batch searching. This required considerable technical development but it replaced a resource allowing us to use the resource in another role. We can’t always create automation for every manual process but there are outside companies that are experts at those processes. If we can get an expert for a lower rate than the cost of performing a manual service internally, we choose the expert.
Transparency builds trust. Patients will have questions and your billing staff should be able to provide consistent answers. Create scripts and train your personnel on patient policies and billing procedures. We’ve created a client portal that lets our clients see customer service notes on each account. Plus we give them reports to measure our service success and they get access to communication tools needed to resolve patient accounts. And for their patients, we provide statements that are incredibly patient-friendly. The statements have a Spanish backside that’s critical in helping the Spanish speaking patient base understand their bill. They’re colorful, legal size, don’t use service description jargon and they include payments and adjustments. Giving your patients the information they need to resolve their bill cuts down on patient calls, gives them a better experience and helps build a relationship of trust.
Each FQHC faces different challenges but we’ve seen these tips work for countless health centers. Try a few of them out and let us know how it goes!
Emerald’s mission is to simplify the patient billing experience. We’ve spent years working to create efficient processes. Our processes have added considerable value to Community Health Center billing departments around the nation. We would like the opportunity to simplify your billing operation in an effort to make it more efficient and scalable. If efficiency and scalability are important to your organization, let’s talk!