Re-engineering the Business Model for Health Centers with Disproportionate Shares of Uninsured and Commercially Insured Patients
April 12, 2013
Federally qualified health centers (FQHCs) are a linchpin of federal health reform, which requires expanded primary care capacity both to care for the influx of newly insured people and to ensure a safety net for those who remain uninsured.
Some FQHCs, however, already serve disproportionately large numbers of uninsured individuals and/or patients with commercial insurance, putting the viability of these health centers at risk. CohnReznick, LLP is an accounting and financial consulting firm that helps community health centers assess their financial performance; address reimbursement and regulatory challenges; conduct strategic planning; and manage risk. With funding from NYHealth, CohnReznick provided technical assistance to five FQHCs with the largest portions of uninsured and commercially insured patients in New York State.
Under this grant, CohnReznick provided the participating FQHCs with strategic guidance to understand the law’s ramifications for their financial operations and to position themselves for financial survival and growth. The project identified the actual impact of coverage expansions on a similar set of FQHCs in Massachusetts in order to construct a financial modeling tool. The financial modeling tool was tailored to the information collected from the participating FQHCs, and was used to predict patient volume, patient revenue impact analysis, and potential impact on staffing and other major expenses. CohnReznick provided individualized technical assistance to the five FQHCs, including conducting webinars and on-site meetings. A summary of the research and analysis was prepared for NYHealth and other stakeholders.