Current revenue cycle management struggles include sustaining and building infrastructures, understaffing, unstable healthcare revenue streams, and few resources necessary to establish new payment models.
The increased patient volumes at community health centers have caused a laundry list of problems. Some of which include sustaining and building infrastructures, understaffing, unstable healthcare revenue streams, and few resources necessary to establish new payment models. The affordable care act provided federally qualified health centers with temporary funding. To resolve these kinds of issues, additional funding is needed and being requested by many of these centers. It is important to realize that there are many federal grants under the Affordable Care Act that are scheduled to end this year.
Sustaining and Building Infrastructures
Many community health centers have expressed their concern about maintaining their current infrastructure without capital funding grants. Many are also worried about clinical service expansions and how they will be able to build to accommodate them in the future.
Healthcare Revenue
Many health centers were able to increase their revenue streams as a result of the Affordable Care Act. This was achieved through various forms of enrollment activities. This Affordable Care Act provided community health centers funding to conduct community events to attract new patients. In many cases, these were successful, as they encouraged new patients enrolled in new health care plans.
Value-Based Reinforcement Models
Many centers are attempting to implement value-based reinforcement models. They need funding, so they can conduct care coordination, team-based care, outcome-based data reporting, and have collaborations with other private providers.
Healthcare Employment
There are many concerns about healthcare employee recruitment and retention. Due to limited funding, many health centers facilities are unable to offer competitive salaries to hiring staff members. Also, there are many centers who are unable to hire a sufficient administrative staff. This causes problems because every center needs a team to be able to handle tasks like grant writing, billing and reimbursement, and monitoring service quality.
Potential Policy Changes
Here are some possible policy changes that may assist the recent medicare cycle management struggles:
-Expand Medicaid to all states to help the revenue streams of community health centers
-Provide insurance coverage for ineligible immigrants and undocumented children
-Provide value-based reimbursement for community health centers by supplying additional resources
-Increase health care employment through various means
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