Community Health Centers: Leadership – Structure – Finance: The Business Model.

Community Health Centers: Leadership – Structure – Finance: The Business Model.

We continue to address Community Health Centers’ central role in providing primary health care to the unemployed, underemployed, and part-time employed who are uninsured or underinsured.

Healthcare in America is not a looming crisis. It is not a pending catastrophe. American healthcare is in a state of crisis now. As has been outlined in prior posts, healthcare for the uninsured and underinsured is a dark waltz with disaster.

If these (unemployed, underemployed, and part-time employed who are uninsured or underinsured) men and women cannot afford adequate food, clothing, or shelter, then, they certainly cannot afford basic, primary healthcare for pre-natal, early childhood, and chronic diseases.

The way this can be dealt with immediately is through well-led, well-managed, and well-financed, local Community Health Centers.

This post addresses:
Community Health Centers - Leadership, Structure, and Finance: The Business Model.

Healthcare Is Unique

Healthcare is a unique, complex, three-way relationship between:
Patient
Physician
Insurer

The Components Of This Unique System Are:
Patients, who consume services but don't generally pay for the entire cost
of medical services...,

Providers, who not only provide, but also prescribe services, in essence
making the decision to buy on behalf of the patient...,

Payors, who neither provide nor consume medical services.


The Business Model Objective and The Expected Results

To implement an effective business to address the mirror issues of consistent quality care and maximum revenue - with the following results:

Leadership
1. Manage the annual budget, monthly financial reporting, and capital improvement planning processes.
2. Develop and implement financial policies and procedures – Including due diligence reviews.
3. Expand Health Programs from single focus to comprehensive services.
Attain scores of over 96% in 3rd party Payor audits.

Structure
1. Developed a full-service, system-wide MIS Department that implements an EMR/IMS process while increasing visits per day and decreasing costs.
2. Enhance managers’ professional skills of planning, organizing, staffing, directing, and monitoring.

Finance
1. Increase monthly revenue by ____
2. Reduce costs by ____
3. Decrease Internal A/R from ____ days to ____ days.
4. Reduce External A/R from ____ days to ____ days.

The Business Model Implementation

Many Community Health Center Boards and Executive Directors talk a good game of being the best, the soonest, with the most; however, as with most things of importance, the devil is in the implementation.

As has been made clear in many prior posts, many Executive Directors do not know how to implement to attain the objective of serving the medically underserved. For instance:
How much has your Center’s patient base grown in the past year?
How much has your visits per day per provider grown in the last year?
Are you growing, or treading water?
What excuses are you, as a Board member, hearing about this failure to grow in serving the underserved?
Is your lack of knowledge keeping your health center from growing to serve the underserved?
Who is responsible for this failure to grow?
Who is being held responsible for that failure?

The Business Model Questions

Is your Community Health Center functioning in a manner that allows it to serve the maximum number of underserved in its area? … Or,

Is your Center operating at the leisure of the providers? … Or,

Has it been operating as a mere boutique business?

Are your hours set to serve the underserved, or to serve the employees?

Does your Governance Board conduct itself in a fiduciary manner – with all the obligations inherent in that role?

Does your Executive Director have the knowledge, skill, values, manners temperament, and experience necessary to do the job?

Is your financial staff giving you the information your need, or just the information that makes your feel better?

Did you actually read, question, and understand the last outside audit?

Did you raise any questions?

Were those questions answered to your satisfaction?

How deep did you dig into last month’s financial statements?

Next series of posts: The Unlearned Lessons of Failing Community Health Centers –In Four Parts.