Revenue Cycle Management Journal Source: The Academy of Healthcare Revenue
Developing Community Clinics to Reduce Uncompensated Care
February, 2007 – The continuing growth in the uninsured population in concert with the reduction of state and federal support programs has many revenue cycle leaders concerned about how to maintain their financial health while providing sufficient community benefit. One solution that some best-performing providers have implemented is creating community clinics—individually or through partnerships with other local hospitals—as a way to provide primary care to uninsured and indigent patients. These clinics can help to give the uninsured and indigent better access to care as well as reduce these patients’ costly visits to emergency rooms, a significant source of bad debt for many hospitals.
When considering whether to develop a community clinic, it is important that revenue cycle leaders analyze all available resources to help offset the costs of maintaining the clinic. Some of the resources available can include the following:
Local providers and clinics. Pooling resources through partnerships with other providers can help to spread the costs of maintaining a community clinic as well as spread the rewards by reducing uncompensated care and enhancing community reputation for all involved.
Volunteers. Soliciting volunteer support in the community to supplement the resources available to clinical staff who serve at the community clinic can help to reduce operating costs. Other volunteer opportunities could include requesting local clinics and pharmacies to donate drug samples. Under guidelines from the Food and Drug Administration, community clinics can accept charitable drug donations so long as an individual authorized by a licensed practitioner inspects all donated medications before use.1
Local, State, and Federal Support. One way that some facilities have funded their community clinics is by working with government leaders to redirect disproportionate share hospital funding (DSH) to help finance the clinic. There may be other similar funding sources available in your community.
Intermountain Health Care, with 20 acute-care facilities throughout Utah and Idaho, decided to open several clinics to serve the Salt Lake City-area’s uninsured and indigent population. Initially, Intermountain first opened four of its Community and School Clinics. The clinics are staffed with family nurse practitioners, RNs, volunteer physicians, and office personnel. Patients’ balances are determined on a sliding scale contingent on patients’ household income status. Staff members at the clinics are also available to help identify patients’ eligibility for charity care or other financial assistance resources.
Intermountain recently opened a new clinic to serve residents in the downtown area of Salt Lake City. Some of the services available include treatment of minor and chronic conditions, immunizations, and medication assistance. The clinic has available resources such as digital x-ray equipment and laboratory facilities, as well as 10 bilingual speakers of English and Spanish to assist patients. Intermountain’s five clinics saw steady growth in their patient visits from 2004 to 2005, as the graph shows.
In addition to Intermountain Healthcare, several other best-performing healthcare providers have recognized the importance of pro-actively reducing the costs of care for the uninsured and indigent. By developing community clinics for the uninsured and indigent populations, hospitals can provide an essential community benefit, while also deterring unnecessary ED use for non-emergent conditions.
1 “Guidance for Industry: Prescription Drug Marketing Act—Donation of Prescription Drug Samples to Free Clincs,” Food and Drug Administration, March 2006
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