National Association of Community Health Centers Americas Voice for Community Health Care

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National Association of Community Health
CentersAmericas Voice for Community Health Care

• Presented by
• Mr. Michael Lardiere
• Director, Health Information Technology
• Sr. Advisor, Behavioral Health
• BPHC All Grantee Meeting June 24, 2008

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National Association of Community Health Centers

• Americas Voice for Community Health Care
• The NACHC Mission
• To promote the provision of high quality,
  comprehensive and affordable health care that is
  coordinated, culturally and linguistically
  competent, and community directed for all
  medically underserved people

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Partners

• Local Hospitals
• Larger Health Systems
• Payers
• Regional Health Information Organizations
• States
• Health Center Controlled Networks

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What is a Health Center Controlled Network?

• Network controlled by and acting on behalf of the
  health center(s), as defined and funded under
  section 330(e)(1)(C) of the PHS Act.
• Controlled means to have the authority
  collectively to appoint a minimum of 51 percent
  of the Networks board members in the Network.
• Has at least 3 collaborators organizations.

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Network Model

• Sustainability Fiction or reality?
• Private companies strive for 3 to 5 year break
  even strategies.
• Cost does not equal price
• Have to become marketing experts..know your
  competition
• Huge capital investment
• Burden of operating expenses
• Requires some payment for services
• Requires diversification of revenue

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Financing a Network

• Capitalization Strategies
• Foundations
• Community Partners
• Federal money
• Community health centers

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Financing a Network

• Other Capitalization Strategies
• Leasing
• Private investor(s)
• Venture capital
• Bonds
• Federal leveraging
• Long term loans

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Financing a Network

• Revenue Drivers
• Services delivered
• Offer financing to CHCs
• Incremental purchasing options
• Market driven pricing and break even analysis
• Stark Laws

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Financing a Network

• What are your costs?
• Define your services dictates manpower
  requirements
• Hardware
• Software
• Training
• Customer Service
• CHC Market
• Health Information Technology
• Network Administration

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Financing a Network

• What are your recurring costs?
• Staff greatest portion of costs
• Hardware
• Software
• Training
• Customer Service
• CHC Market
• Health Information Technology
• Administration

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Financing a Network

• What impacts cost?
• Implementation speed
• Readiness of organization
• Product development
• Customizations
• Payor and/or federal requirement changes
• Data reporting requirements
• CHC staff turnover/Network turnover

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Financing a Network

• Creating Value
• Explicit vision, clear outcomes and goals
  define value
• Different stakeholders different values
• Measure outcomes of utilization
• Improve health outcomes through best practice and
• research
• Build community value through quality initiatives
  and
• interoperability

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Value of a Network and HIT

• Increase in payments received per visit
• Decrease in days in A/R including self pay
  patients
• Total 5 yr costs for EMR - less than off the
  shelf products
• Influencing HIT agendas
• State
• Federal

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Value of a Network and HIT

• Decreased eligibility denials
• Increase visits/FTE
• PBRN (Practice-based Research Network)/Quality
• Data sharing
• Improved opportunity for successful
  implementations
• Improved opportunity to remain within budget no
  hidden cost

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Community Health Center

• Financing Strategies
• Foundations
• Payer support
• Regional Health Information Organizations (RHIOs)
• HCCN may be offering terms
• Pay for it themselves

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Community Health Center

• Offsetting Expense Strategies
• Reduced or no dictation
• Increase cycle time from automation
• Reduced or no charge entry staff
• Reduction in medical record staff
• Recouped staff time from lost records
• Reduced days to send claim to less than 24 hrs

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Grant Opportunities

• Grants.gov
• http//www.grants.gov
• Specific State Office of Information Technology
• Forum of Regional Associations of Grantmakers
• http//www.givingforum.org/s_forum/index.asp
• The Foundation Center
• http//foundationcenter.org/

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Grant Opportunities

• Google Alerts
• http//www.google.com/alerts
• Health IT Grant Resource Directory (paid service)
• http//hittransition.com/index.htm
• U.S. Department of Agriculture
• http//www.usda.gov

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Grant Opportunities

• Grant Resources on the Internet
• http//www.GrantResources.info
• Capital Link
• http//www.caplink.org
• Review NACHCs Weekly Grant Announcements
• - Distributed every Thursday when grants are
  identified

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Capital Link Background

• Mission Capital Link is a national nonprofit
  organization
• We assist health centers in planning and
  obtaining financing for building and equipment
  projects, and
• We assist Primary Care Associations (PCAs) and
  other partners in leveraging capital resources
  for health centers on a statewide, regional
  and/or national basis
• Staffed in nine offices (CA, DC, LA, MA, MD, MO,
  NC, WA,
• WV)
• Receives funding through contracts with HRSA,
  some private foundations and through fee-based
  contracts to assist health centers and PCAs
  nationally

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Office of Health Information Technology

• AHRQ National Resource Center Portal
• For HRSA Grantees
• http//healthit.ahrq.gov/login
• If attendees do not have an account for the HRSA
  Health IT Portal, please send an e-mail to the
  following e-mail address HealthIT_at_hrsa.gov
• If attendees have additional questions or
  suggestions, please call the National Resource
  Center for Health IT at 1-866-356-3467 or
• e-mail us at NRC-HealthIT_at_ahrq.hhs.gov

• US Department of Health and Human Services
• Health Resources and Services Administration
• Office of Health Information Technology

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NACHC Health Information Technology

• Michael Lardiere, LCSW
• Director, Health Information Technology
• Sr. Advisor, Behavioral Health
• National Association of Community Health Centers
• mlardiere_at_nachc.com