News Archives - Practice Management

People keep the mission alive. For FQHCs, recruiting and keeping great clinicians and excellent administrative staff is as strategic as improving access to care. But 2025 is a tough hiring market: demand for services is up, funding is uncertain, and experienced candidates can and do pick higher-paying or less stressful roles elsewhere. The good news: there are practical, affordable steps FQHC leaders can take right now to become employers of choice — and some of them don’t require big budget moves.

The landscape: why this matters now

FQHCs are feeling the squeeze. More than 70% of community health centers report critical shortages of primary care clinicians, nurses, or mental-health providers — staffing gaps that directly threaten access and continuity of care. At the same time, the financial strain of replacing staff, covering vacancies with overtime or travelers, and managing onboarding is real and measurable. If your center can reduce turnover and speed hiring, you protect both mission and margin.

Hire like you mean it: recruitment tactics that work

A targeted recruiting approach helps you find the right people faster and creates a better candidate experience, which matters in a tight labor market.

Pay and benefits: be competitive and creative

You don’t always have to match hospital salaries dollar-for-dollar to be attractive, but you do have to be realistic and creative.

Career growth and culture: retention wins start here

Compensation gets candidates in the door; growth and culture keep them. Invest where the ROI is obvious: training, leadership pathways, and manageable workloads.

Strategic outsourcing: a way to access top talent without long hiring cycles

Outsourcing parts of revenue cycle management (or other back-office functions) is not a replacement for building your team, it’s a lever to give staff breathing room, access expertise, and improve performance while you recruit.

Quick wins CFOs can implement this quarter

If you’re a CFO or RCM leader, here are practical next steps you can roll out quickly:

Final note — invest in people to protect the mission

Attracting and keeping talent at your FQHC isn’t just a human resources exercise, it’s a financial and mission imperative. Workforce shortages are real and costly; replacing clinicians or skilled RCM staff can exceed tens of thousands of dollars and take months. By combining better pay benchmarking, career pathways, targeted benefits, and smart use of outsourcing, FQHCs can become employers of choice without sacrificing fiscal responsibility.

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As we near the end of the year, many of the healthcare organizations we work with are beginning to look forward and plan for 2024. Part of this planning is updating, or even creating, a strategic plan. Strategic planning can be defined as “a process used by organizations to identify their goals, the str

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Attracting and Retaining Top Talent at Your Health Center

Posted on October 17, 2025February 10, 2026 by Carolyn Yoder

The landscape: why this matters now

Hire like you mean it: recruitment tactics that work

A targeted recruiting approach helps you find the right people faster and creates a better candidate experience, which matters in a tight labor market.

Leverage NHSC & state loan-repayment programs. Promote NHSC and State Loan Repayment openings on your job posts and in interviews if applicable; clinicians often choose FQHCs because of loan relief. These programs are a proven recruitment tool for underserved sites and are administered through HRSA.

Market your mission and community impact. Clinicians who care about equity and SDOH often prioritize purpose. Use patient stories, community metrics, and outcomes in recruitment materials to attract mission-driven candidates.

Build relationships with training programs. Offer rotations, preceptorships, and residency partnerships. Early exposure to community health increases the odds trainees will choose to stay.

Use data to prioritize hires. Focus on roles that unblock capacity (e.g., behavioral health clinicians or care coordinators) so clinicians can spend more time with patients, improving job satisfaction and productivity.

Pay and benefits: be competitive and creative

You don’t always have to match hospital salaries dollar-for-dollar to be attractive, but you do have to be realistic and creative.

Benchmark and be transparent. Use regional salary data (and update annually) so offers are defensible and fair; transparency builds trust during negotiations.

Make benefits count. Flexible scheduling, predictable clinic hours, loan repayment assistance, paid leave, and robust mental health benefits can matter as much as base pay for clinicians and admin staff. Consider small yet high-value perks — a professional development stipend, hybrid work options, license renewal support, or telehealth-friendly schedules.

Consider creative pay levers. Signing bonuses, retention bonuses, and targeted differential pay (e.g., for bilingual clinicians) can close immediate gaps while you build long-term solutions.

Career growth and culture: retention wins start here

Compensation gets candidates in the door; growth and culture keep them. Invest where the ROI is obvious: training, leadership pathways, and manageable workloads.

Create clear career ladders. Define promotion tracks for RCM staff, medical assistants, billers, and care coordinators. When people see a future, they are likely to stay longer.

Invest in regular, relevant training. Cross-training between front-desk, coding, and billing roles reduces single-person bottlenecks and increases staff flexibility. This protects your staff from quickly burning out and gives them more skills they can use in their professional life. Offer protected time for learning so they don’t view learning as a burden that keeps them from accomplishing their day-to-day work.

Support wellbeing and reduce burnout. Small changes like consistent schedules, protected documentation time, and access to EAP services make a difference for retention. Use staff surveys and ‘stay interviews’ to identify what matters most to your team. Don’t wait until they are walking out the door to ask them what you could be doing differently.

Recognize and celebrate wins. A culture of appreciation (shout-outs, quarterly awards, development funding) costs little and signals that leadership values people, not just productivity.

Strategic outsourcing: a way to access top talent without long hiring cycles

Free up clinicians and admins. Offloading AR cleanup, denial management, or complex payer contracting reduces the day-to-day burden on small teams and prevents burnout that drives departures.

Access specialized expertise. Experienced RCM vendors maintain coding experts, denial teams, and reporting analysts — skills that can be hard to recruit locally and expensive to train in-house. Industry benchmarks suggest top RCM operations aim for net collection rates in the mid-90s and clean claim rates above 90–95%, targets that many in-house teams struggle to reach without scale and technology.

Do the homework. If you outsource, choose a partner with FQHC experience (sliding fee scale, PPS, Medicaid managed care) and clear KPIs (net collection rate, denial rate, days in A/R) so you can measure value. You also want to consider your community and your mission – finding a billing company that has great communication and a passion for supporting your mission ensures you’re working with a company that won’t just treat you like another number.

Quick wins CFOs can implement this quarter

If you’re a CFO or RCM leader, here are practical next steps you can roll out quickly:

Run a compensation market scan for your top 10 high-turnover roles and adjust offers where you are below median.

Post 2–3 NHSC-eligible roles prominently and update recruitment copy to highlight loan repayment and mission impact.

Pilot a one-to-three-month RCM task outsourcing (e.g., denial backlog cleanup) and measure recovered revenue vs. cost. Use those results to decide if broader outsourcing is a fit for you.

Launch a small professional development fund ($1,000–$2,500/year per staff person) targeted at RCM and admin staff and track retention change after 12 months.

Start a monthly “stay” check-in for high-risk roles: ask what would make them stay and act on at least one feasible suggestion.

Final note — invest in people to protect the mission

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The current Role of Telehealth: Financial Benefits and Challenges

Posted on September 15, 2025February 10, 2026 by Carolyn Yoder

Delivering Care in a Changing Landscape

In the wake of COVID, telehealth transformed from a stopgap measure into a strategic pillar of healthcare delivery. It opened doors to patients who otherwise would have gone without care, particularly those in rural areas, underserved populations, and individuals with behavioral health needs. Now, in 2025, telehealth is here to stay, but the rules around reimbursement are shifting. For healthcare leaders, especially in primary care, behavioral health, and FQHCs, it’s time to take a look at both the financial and patient-centric benefits to telehealth, as well as the challenges on the horizon.

The Current Financial Landscape: Where Telehealth Stands

The pandemic-era flexibilities that expanded telehealth access have not been made permanent. Instead, temporary extensions have been approved through September 30, 2025, keeping most Medicare telehealth services reimbursable until then. After that date, unless things change, many of those services will face restrictions again.

Key changes expected (but not confirmed) after September 2025 include:

Geographic restrictions returning, limiting services to rural sites or designated facilities.
Patients required to be at approved originating sites, such as clinics or hospitals.
Audio-only visits limited exclusively to behavioral and mental health services.

For now, providers should plan for flexibility: maximizing opportunities while they exist and preparing for reimbursement cuts or rule changes ahead.

A Financial Bright Spot: Behavioral Health Telehealth Access

While many telehealth flexibilities are set to expire, behavioral health remains the exception and a financial bright spot for healthcare organizations. Behavioral health telehealth services, including audio-only visits, are covered indefinitely, without the geographic or originating site restrictions applied to other services.

This is a major win for both patients and providers. Consistent access means more reliable revenue streams and the ability to continue serving vulnerable populations who may struggle with transportation, technology, or stigma. For clinics offering behavioral health, this ongoing flexibility provides a strong foundation to build sustainable hybrid care models that balance in-person and virtual care.

Financial Benefits of Telehealth in Modern Healthcare

Telehealth continues to provide meaningful financial advantages even as regulations tighten. For many organizations, these benefits go beyond cost-savings and help create stability and expand access in ways that support long-term sustainability.

Some of the key financial benefits include:

Lower Operating Costs: With fewer in-person visits, healthcare organizations can reduce overhead associated with exam rooms, utilities, and other facility costs.
Expanded Access, Sustained Revenue: Telehealth helps maintain appointment volumes, especially for behavioral health, where patients are more likely to keep virtual visits.
Telehealth Use Persists: Even though COVID-era peaks are behind us, telehealth utilization remains nearly double pre-pandemic levels.

These benefits mean that even as reimbursement rules evolve, telehealth can still play a crucial role in stabilizing revenue.

Challenges Leaders Need to Anticipate

Of course, the financial picture isn’t entirely rosy. Healthcare leaders must plan now for the challenges that could affect their bottom line later this year and into 2026. The expiration of waivers means increased complexity and possible reimbursement cuts that can’t be ignored.

Key challenges include:

Shrinking Access Post-September 2025: Without congressional action, many primary care and specialty telehealth services will lose reimbursement support.
Reimbursement Reductions: Certain services may receive lower payment rates or require additional documentation, creating administrative strain.
Administrative Burdens Return: Providers will once again need to document originating sites, in-person visit requirements, and strict compliance protocols.
Policy Uncertainty: Advocacy groups continue pushing for extensions, but until legislation passes, providers face ongoing financial unpredictability which makes planning for the future difficult.

Preparation and adaptability will be essential to weathering these changes.

Special Considerations: Telehealth for FQHCs

For Federally Qualified Health Centers, telehealth provides both opportunities and hurdles. Behavioral health services remain a reliable telehealth revenue source, including audio-only visits. But once waivers expire, distant-site restrictions may prevent FQHCs from being reimbursed for non-behavioral telehealth unless the patient is at the facility.

For FQHC leaders, this makes tele-behavioral health a critical area of focus. By emphasizing these services to the populations they serve, FQHCs can strengthen their financial resilience while continuing to meet community needs.

What Healthcare Leaders Can Do Now

With big changes ahead, healthcare leaders should act now to prepare. The good news? There are concrete steps that can be taken to safeguard revenue and strengthen workflows, even in an uncertain policy environment.

Strategies to consider:

Audit Current Telehealth Workflows: Track which services are being provided via telehealth and where they fall under current flexibilities. This also gives you a big-picture view of what services will need to be radically, or just moderately, adjusted depending on policy shifts.
Prepare for Policy Shifts: Build workflows that can flex between in-person and telehealth billing depending on reimbursement rules. Flexible workflows reduce stress on your team and allow your organization to be agile in response to changing rules and regulations.
Leverage Behavioral Health Telehealth: Expand behavioral health offerings, knowing these services have stable long-term reimbursement. Expanding these much-needed services provides invaluable support to your community, and can generate revenue that can be funneled into other vital services that may no longer be generating as much of their own revenue.
Engage with Advocacy Efforts: If it makes sense for your organization and mission, join coalitions working to extend telehealth flexibilities and protect provider reimbursement.

Looking Ahead with Confidence

Telehealth may look different in 2025 than it did during the height of the pandemic, but it’s still a vital piece of the healthcare puzzle. For primary care, behavioral health, and FQHCs, the financial benefits, especially for behavioral health, are too important to overlook. By preparing now, healthcare organizations can adapt, stay financially resilient, and continue delivering care that meets patients where they are.

For more insights into strengthening your billing operations in changing times, explore our Resource Library filled with practical guides and webinars-on-demand.

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Sustainable Growth: Balancing Expansion and Financial Prudence

Posted on June 5, 2025February 10, 2026 by Carolyn Yoder

FQHCs exist to meet the needs of their communities, and those needs are growing. Community health centers across the nation are facing increasing demand for behavioral health services, rising numbers of uninsured patients, and a push for more mobile and school-based care. All of these factors mean one thing: Expansion! But with 2025 funding uncertainty and inflation-driven costs, plus the age-old staffing issue for health centers that struggle to compete with incentives offered by other types of healthcare organizations, growth at your FQHC must be carefully balanced with financial sustainability.

The good news? You don’t have to choose between mission and margins! With thoughtful planning and smart financial strategies, FQHCs can scale their impact without sacrificing financial stability.

Start with a Community-Centered Needs Assessment

Before expanding, it’s critical to confirm that your plans are aligned with what your community actually needs. Growth for growth’s sake can drain resources and miss the mark, causing you to pour valuable time and resources into a project that may sound good on paper, but doesn’t translate into community impact.

Engage with your patient base and community partners through surveys, focus groups, or informal listening sessions. This helps ensure you’re adding services or locations that will truly meet a demand.

Use UDS and internal data to identify care gaps. Look at trends in missed appointments, ER referrals, or chronic condition management to target where investment could have the biggest impact.

Prioritize services that are both mission-aligned and financially sustainable. Behavioral health, chronic care management, and dental services are often in high demand and eligible for reimbursement.

Build a Phased Expansion Plan

Trying to grow too quickly can stretch your team thin and strain your finances. A phased approach helps you test, evaluate, and adapt as you go, which helps keep any expansion sustainable for the long run.

Start small and scale intentionally. For example, pilot a part-time behavioral health provider before hiring a full team. Or test mobile unit deployment a few days a month before expanding to a full schedule.

Break larger initiatives into milestones. This makes it easier to track your progress and manage your budget, while creating natural checkpoints for evaluation.

Ensure leadership and staff alignment. Expansion should feel like a shared mission, not a top-down directive. Involving your team in the planning process creates buy-in and reduces burnout. Since your staff will be the boots-on-the-ground workers for any new programs and services, they can provide valuable feedback on processes and procedures, plus realistic opinions on staff bandwidth and community needs.

Protect Cash Flow During Growth

Even mission-driven expansion needs solid financial footing. New programs or service lines often take time to become self-sustaining, so protecting your cash flow in the meantime is key.

Budget for a ramp-up period. Don’t expect new programs to generate immediate returns. Build a financial cushion for the first 6–12 months before launching.

Monitor performance monthly. Track both clinical and financial outcomes early to catch issues before they escalate. If a new initiative isn’t delivering, adjust quickly – don’t feel the need to keep going if you’re not able to create impact.

Outsource high-effort, low-reward tasks like claims follow-up or AR cleanup. This reduces the burden on in-house staff, maximizes your cash flow to reduce risk, and frees up resources for patient-focused work.

Leverage Strategic Partnerships

You don’t have to go it alone. Collaboration with other community-based organizations can amplify your reach and reduce the financial burden of expansion.

Partner with schools, shelters, or housing organizations to co-locate services. This extends your reach without the cost of new facilities.

Work with local hospitals or specialists to coordinate care or share grant funding. Joint efforts around diabetes or maternal health, for example, can attract new resources. Creating a concentrated marketing push sharing your resources with other specialists in your area can also raise awareness of your services and increase referrals from providers that are looking for additional patient support.

Tap into regional networks or PCAs for shared staffing, training, or purchasing power. These relationships can improve efficiency and reduce overhead, plus provide great networking and educational opportunities for your staff.

Stay Mission-Focused—but Data-Driven

Your mission is your compass, but data is your map. Tracking the impact of your expansion ensures you’re meeting your goals without drifting off course financially.

Develop KPIs that reflect both patient outcomes and financial health. For example: improved access, reduced no-show rates, and cost-per-visit benchmarks.

Share results with your board and staff regularly. Transparent communication reinforces a shared commitment to smart, sustainable growth, and keeps everyone invested in your “why.”

Use the data to tell your story. Strong reporting can support future grant applications, partnerships, and payer negotiations. A robust report speaks volumes in the professional world, and investing in some easy-to-read marketing pieces like infographics or short-form videos can connect the public to your mission as well, creating buy-in and community support for your FQHC.

In conclusion…

Growth doesn’t have to mean overextension. With a clear plan, grounded in community needs and financial clarity, FQHCs can expand their impact while staying true to their mission. The goal isn’t just to do more, but to do more of what matters, sustainably.

Thinking about expanding services or improving your revenue cycle before you grow? Let’s talk. We’re here to support your mission with strategy and expertise.

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Understanding the Prospective Payment System for FQHCs

Posted on May 26, 2025February 10, 2026 by Carolyn Yoder

For Federally Qualified Health Centers, the Prospective Payment System (PPS) is more than just a billing mechanism, it’s the foundation of how the care you provide your patients is reimbursed. And in today’s uncertain funding landscape, understanding how PPS works (and how to work it to your advantage) is critical for maintaining financial stability for your healthcare organization.

Whether you’re new to the FQHC space or just need a refresher, this post breaks down PPS in plain terms, outlines its financial implications, and offers practical strategies for optimizing your reimbursements in 2025.

What Is PPS? A Quick Overview

The Prospective Payment System is a method used by Medicare and Medicaid to reimburse FQHCs for patient visits. Instead of being paid per service (like in fee-for-service models), FQHCs receive a flat, predetermined rate (called the PPS rate) for each qualified visit, regardless of how many services are provided during that visit.

This approach simplifies billing in some ways but also presents challenges if your documentation, coding, or visit tracking isn’t aligned with PPS requirements.

The Financial Implications of PPS for FQHCs

PPS is designed to ensure that health centers receive consistent payments, but reimbursement levels can vary based on how well your center manages its billing and documentation processes.

Underreporting or incomplete visit documentation means lost revenue. If a visit doesn’t meet the qualifying criteria (for example, missing a face-to-face interaction), it may not be reimbursed at the full PPS rate.

PPS rates are adjusted annually but often lag behind real inflation. In 2025, many FQHCs are experiencing rising operational costs that are outpacing PPS rate increases, particularly for staffing and supplies.

Each FQHC’s PPS rate is unique. It’s based on historical cost data and must be managed carefully to ensure it reflects your current service scope and patient population.

Strategies to Optimize PPS Reimbursements

While PPS can feel rigid, there are several ways to improve how your health center operates within the system. These strategies can help ensure you’re not leaving your hard-earned revenue on the table.

Ensure accurate coding and documentation for every visit. Each PPS-eligible encounter must include specific elements (like a qualified provider and face-to-face interaction). Training providers and front-office staff on PPS requirements helps them self-monitor their documentation and prevent missed opportunities.

Track and reconcile every billed visit. Monitor which encounters are denied or underpaid and investigate why. A simple monthly review of denied PPS claims can uncover patterns your team have fallen into that can be easily fixed, like incorrect modifiers or provider credentialing issues. Finding those small issues and addressing them can create a big impact on your financial stability.

Use your data to request rate adjustments. If your service mix or patient population has shifted significantly since your PPS rate was set, you may be eligible to update your rate. This requires strong internal reporting and financial documentation, so setting up processes now to capture and report on this data can pay off in a big way down the road.

Stay current with state-specific PPS rules. Medicaid PPS methodologies vary by state. Some allow for Alternative Payment Methodologies (APMs), which can offer more flexibility. Understanding your state’s rules helps you choose the most advantageous option.

Leverage external support where needed. If your team is stretched thin, consider outsourcing billing or engaging RCM experts familiar with PPS rules. Finding an outsourcing team that is familiar with FQHC billing means they can flag trends, correct underpayments, and ensure compliance without adding to your internal workload or payroll.

Final Thoughts

The Prospective Payment System can feel like a moving target, especially when costs are climbing and funding remains uncertain. But with a strong understanding of how PPS works, and a few operational tweaks, FQHCs can better capture the revenue they’ve already earned.

Need help improving your PPS performance or cleaning up denied claims? Let’s talk. We’re here to handle the complexities of your billing and help you stay focused on what matters most: caring for your community.

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Employee Wellness Programs: Investing in Your Greatest Asset

Posted on April 28, 2025February 10, 2026 by Carolyn Yoder

Running a successful healthcare organization means more than hitting financial targets or meeting patient volume goals—it means taking care of the people who make your mission possible. Your staff are your greatest asset, and when they’re overwhelmed, overworked, or burnt out, everyone feels the ripple effects: patients, coworkers, leadership, and ultimately, your bottom line.

Employee wellness isn’t just a “nice to have” anymore. It’s a strategic investment that can increase productivity, reduce turnover, and create a workplace culture that people actually want to be part of. And the best part? You don’t need a huge budget to make a big impact.

Why Wellness Programs Matter More Than Ever

Staff burnout is a serious issue in healthcare, and especially for community health and FQHCs facing continued staffing shortages and uncertain funding. Even as this issue becomes more prescient than ever before, workplace wellness is often misunderstood. Creating space for wellness in the workplace isn’t about spa days or gym perks, it’s about making employees feel supported, valued, and set up to succeed.

Burnout is expensive. According to the National Academy of Medicine, turnover due to burnout can cost up to 2x an employee’s salary. Losing just one experienced biller, provider, or administrator can disrupt patient care and drain organizational resources.

Wellness boosts productivity. When employees feel mentally and physically well, they’re more focused, more engaged, and more effective in their roles. Even small breaks or flexible work options can have measurable effects.

Retention improves with culture. A positive work environment where people feel seen and supported is more likely to retain employees, especially in high-stress healthcare settings where competition for talent is fierce.

Building an Effective Wellness Program—Without Overwhelm

Creating a wellness culture doesn’t have to mean launching a full HR initiative overnight. Small, intentional steps can build momentum and make a real difference.

Offer flexible scheduling when possible. Even a few hours of schedule autonomy can help staff manage family responsibilities, appointments, or mental health needs without stress. It’s a signal that leadership trusts and respects their time.

Encourage regular check-ins and peer support. Whether it’s monthly team debriefs or buddy systems, connection reduces isolation and helps identify problems before they snowball. These don’t need to be formal HR events, just structured space to listen and check in.

Make mental health resources accessible. Free or low-cost EAPs (employee assistance programs), community-based counseling partnerships, or even curated lists of trusted local therapists go a long way toward removing the stigma around seeking support.

Promote movement and breaks during the day. Encourage short walks, stretch breaks, or even standing meetings. Offering gym memberships as a perk is a wonderful idea, but not always practical for healthcare organizations stretched thin on budgets. Physical wellness doesn’t need a gym membership, just the freedom to step away for a few minutes and move your body.

Ask for feedback and act on it. Surveys, suggestion boxes, or anonymous forums can help leadership understand what employees really need. Implementing even one small change based on staff feedback builds trust and shows commitment.

Reduce Burnout by Reducing the Burden

When your internal teams are buried in paperwork, billing errors, or compliance updates, wellness efforts can feel like just one more thing to manage. Some ideas to lighten the load?

Outsource time-consuming financial tasks like revenue cycle management. You can also consider an examination of current processes and procedures to identify duplications of effort and inefficiencies that add work without improving workflows. While not the centerpiece of a wellness program, these efforts can create real breathing room for your team to focus on patients and each other.

Final Thoughts

Your people are your mission in action. Investing in their well-being is one of the smartest moves your leadership team can make, especially in today’s healthcare landscape where burnout and turnover are common. Whether you’re rolling out a new wellness program or just starting the conversation, what matters most is showing your team they matter.

Want more ideas for reducing staff stress and optimizing internal workflows? Check out some more blog articles covering employee wellness and retention, and read up on how outsourcing strategic services can help your healthcare organization maintain balance. Interested in learning more? Let’s talk about how we can support your goals.

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How to Get a Chronic Care Management Program Started Fast

Posted on September 27, 2017March 26, 2019 by Carolyn Yoder

by John Zulaski, President, Practice Management

Practice Management is a participating partner in the Center for Medicare and Medicaid Services (CMS) Connected Care program, promoting the value and benefits of Chronic Care Management (CCM) services. We seek to help bring providers and patients a valuable service. Providers engaging CCM services benefit from significant financial incentives, improved outcomes, and the potential to reduce administrative burdens. Patients benefit through consistent contact with the care team directing them to needed resources such as their healthcare provider and to direct them away from harm.

As the challenge of providing these additional services in-house has been examined, a strong need for assistance has been identified by many companies specializing in CCM. Challenges include hiring and managing productivity. The biggest challenge is to meet the 20 minute requirement for 90% or more of enrolled patients.

The outsourced CCM is an elegant solution that is being rapidly adopted by healthcare providers large and small. Most companies offer a software solution or a fully staffed CCM team. While many provider organizations feel the best solution is to perform the task in-house, the delay while building and training the CCM team may be costly. Delay means months going by with no service performed, and no revenue. A viable plan that doesn’t leave money on the table might be to start with the full service option and transition to in-house at a comfortable pace.

Costs of these services range from 50-65% of the per patient per month reimbursement with the remainder left as practice profit. Once the program is up and running, there is very little for provider offices to do except to help patients enroll (generally by verbal consent). The financial impact can be substantial given that most Medicare patients meet the requirement of two chronic conditions. A practice with just 10,000 Medicare patients participating monthly (and only performing the basic 20 minute service) would see $140,000 to $200,000 per month after paying the outside CCM service. That’s $1,680,000 to $2,400,000 per year!

CMS continues to roll back barriers to participation in an effort to invest in the savings that CCM is expected to generate. Could CCM benefit your patients?

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NACHC 2017 FOM/IT Conference

Posted on August 16, 2017April 15, 2019 by admin@maximized

October 25-27, 2017
NACHC 2017 Financial, Operations Management/IT Conference (FOM/IT)
Planet Hollywood, Las Vegas, NV

Practice Management recently exhibited at the 2017 National Association of Community Health Center’s Financial, Operations Management /Information Technology (FOM/IT) Conference in Las Vegas, October 26-27, 2017.

The FOM/IT Conference attracts more than 700 health center CEO’s, CFO’s, COO’s, CIO’s and health center finance, operations and IT staff from around the country who are seeking best practices and innovative solutions to their most pressing challenges. The FOM/IT conference is the best place for health centers to connect with their peers, leading experts from the field, and prospective partners to identify key strategies and tactics and to share best practices and lessons learned to optimize their health center for financial and operational success.

Let’s face it; we live in a world where demands for consumer’s cash appear at every turn. U.S. marketing to consumers focuses on making life better; all you have to do is purchase the next product or service to get your trip to nirvana. On the other hand, medical bills are for services already provided often with negative connotations such as sickness, injury, and problems. After the rent, cable and cell phone bills are paid the stack of medical bills is considered. Healthcare organizations cannot compete with the demands for cash our society places on the average patient. If you do not collect when the patient is in the mood to pay, you risk not collecting at all.

With those barriers in place, we need to make it as easy as possible to collect from patients who may have the impulse to pay. We cannot put barriers up that make payment more difficult.

Every possible avenue for easy access to payment needs to be open. All major cards need to be accepted, electronic checks, cash, etc. Yes, you need to take AmEx, weigh the cost of service fees against the 85% or more loss if you don’t take the payment when the patient is in the mood. Payment methods need to be easily accessed with the fewest hurdles by phone, by web, or in person.

Easy Access

The “Pay My Bill” button on your website needs to be in a prominent position.

Figure out a way to accept web payments without having the patient set up a login.

Take payments from anyone offering. HIPAA should not throw a barrier up when the spouse who handles the bills wants to set up a payment plan for their partner.

Make sure all support staff can take an immediate payment when the patient makes the attempt.

Set simple policy for accepting payment plans, offer prompt pay discounts, and offer discounts to resolve very old balances.

Make the policy simple enough to give authority to as many staff as possible.

Get creative.

The cost of discounts and payment plans can be weighed against the loss of uncollectible debt. Could a 50% or 70% discount vs. 100% write-off be a better financial deal for the healthcare provider? Does it make sense to offer huge goodwill discounts on longstanding debt rather than fighting to the finish at a third party collection agency? Maybe… An open mind and open access are needed to address the most difficult area of healthcare finance.