Updates from your ACE team

Welcome to the second quarter of 2021! We made it and as we progress through the rest of the year, it is important to review how you can maximize your revenue through our revenue cycle management (RCM), 340B Pharmacy - through the 340B Program - and practice expansion services. This newsletter focuses on driving revenue through proper RCM processes and practice expansion. This newsletter explains how expanding a practice to treat the same chronic health conditions that cost employers billions can boost and drive your revenue while providing better health care to all. Speaking of practice expansion and chronic health issues, one of today’s leading chronic issues - tooth decay - is treated through dentistry; Health Resources and Services Administration (HRSA) is currently offering funding to advance dental programs. This newsletter shares the Biden Administration’s recent developments and the U.S. Department of Health and Human Services’ (HHS) latest funding for community health centers to expand COVID-19 vaccinations, new COVID-19 reimbursement rates from Centers for Medicare and Medicaid Services (CMS) and HRSA and the Centers for Disease Control and Prevention’s (CDC) latest funding advancement in its attempt to help beat the pandemic.

RCM solutions FQHCs trust to maximize their revenue

RCM can be a series of complicated processes that - if not executed carefully or correctly - can cost community health centers greatly. From the credentialing of providers and facilities so both can be paid the correct rate from the start, creating and scrubbing a claim correctly the first time, to decreasing and managing denials, working the A/R and tracking the self-pay now, Medicaid later patient population (retro Medicaid Payment) to avoid potentially massive and premature write-offs; we are experts at looking to increase and maximize your revenue through our extensive RCM services.

Let's talk about driving your revenue by decreasing your denial rate to less than 7 percent together.

HRSA's COVID-19 uninsured program increases vaccine administration rates

Most are desperate to bring an end to the COVID-19 pandemic and get back to normal life. In effort to do so, the Biden Administration has invited more community health centers to participate in an initiative to vaccinate those that are underserved and uninsured. Payers are starting to increase incentives to facilities for doing their part to provide COVID-19 vaccines. CMS increased its reimbursement rate for the COVID-19 vaccine(s). The increased reimbursement “rate [supports the] important actions [providers and facilities are taking] to increase the [daily] number of vaccines [provided and the number of people vaccinated. This includes] establishing new or [expanding] existing vaccination sites, conducing patient outreach and education and hiring additional staff. COVID-19 vaccines [that are] administered on or after March 15, 2021, will be [reimbursed] $40 [per] dose. The exact payment rate for administration of each dose will depend on the type [and the location] of entity” providing the vaccine(s). HRSA released a program, Uninsured Program, which aligns with CMS’ payment rate and almost doubles the reimbursement rate to those administering the COVID-19 vaccines to those that are uninsured. “Health care entities that have conducted COVID-19 testing of uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020, [may] request reimbursement through the program electronically and will be reimbursed at Medicare rates. [This is] subject to available funding.” “’Everyone in America should have equal opportunity to be as healthy as possible,’ said CDC Director Dr. Rochelle P. Walensky.” Joining in on the advancement of COVID-19 is none other than the CDC. The CDC believes that health is an equal, important personal choice. The organization plans to “invest $2.25 billion over two years to address COVID-19-related health disparities and advance health equity among populations that are at high-risk, underserved and [those that live] in rural areas.” The plan offers: Grants to public health departments to improve testing and contact tracing capabilities Develop innovative mitigation and prevention resources and services Improve data collection and reporting Build, leverage and expand infrastructure support Mobilize partners and collaborators to advance health equity and address social determinants of health as they relate to COVID-19. The Biden Administration has a plan to expand the COVID-19 vaccine roll out to 950 community health centers, increasing the total by 700 community health centers to serve and vaccinate those that are uninsured and/or underserved. According to a fact sheet released on March 25, 2021, in its COVID-19 response, “HHS will invest nearly $10 billion to expand access to vaccines and better serve communities of color, rural areas, low-income populations and other underserved communities. [The purpose of] this funding [is to] expand access to vaccines for vulnerable populations and increase vaccine confidence [nationwide]. HHS will invest more than $6 billion from the American Rescue Plan into community health centers nationwide. [Starting in April] HRSA will provide funding to nearly 1,400 centers.” Click here for information detailing how this funding is being distributed to health centers, including state-by-state breakdowns and an interactive funding map.  Click here for the list of HRSA’s FAQs for COVID-19 Reimbursement to health care providers and facilities for testing, treatment and vaccine administration.

Are you billing the COVID-19 vaccines correctly and receiving the correct reimbursement rate? Our Medical Billing Specialists can help ensure you get paid right the first time for your integral part in achieving herd immunity while also protecting your patients and driving your revenue.

Practice Expansion: Profiting off the five chronic conditions that cost employers $2.5 billion over 2 years

It’s not a secret that Americans struggle with chronic illnesses and conditions. Between overly successful fast-food chains like McDonalds on every block, super-sized sodas offered for no additional monetary cost and a culture that recognizes those that work around the clock instead of those that have a healthy work life balance, it’s not surprising that we have a massive amount of chronic health conditions throughout the country. Most chronic health conditions are preventable through a healthy diet and lifestyle. Because employers pay for health, dental and vision insurances - at a basic plan level - it’s not that surprising that employers end up paying “90 percent of the nation’s $3.8 trillion in annual health care expenditures for people with chronic and mental health conditions.” Heart disease and stroke are the culprit for the highest number of cause of deaths, totaling at one third. Heart disease and stroke is followed by cancer, diabetes, obesity, arthritis, Alzheimer’s, Epilepsy and untreated cavities (tooth decay). What are the causes of these diseases? According to the article, the causes are all controllable issues: smoking, lack of physical activity and excessive alcohol use. With the majority of Americans suffering from these - sometimes lifelong - illnesses, it’s essential to your business practices, patient growth and revenue to have providers that can treat these issues and allow your patients to fill their recurring prescriptions through your 340B Pharmacy - in-house or contracted.

Let's talk about your patient's chronic conditions, what medications they need and which like-minded practices you have close to you that can create partnerships to best serve your patients.

Practice Expansion: Dentistry encompasses a better bill of health

We’ve mentioned that cavities and tooth decay can cost employers a pretty penny. “One in five children ages 6 to 11 and one in four adults have untreated cavities. On average, 34 million school hours are lost each year because of emergency dental care.” Dentistry is key to fighting and managing chronic health conditions that also lends a hand in providing patients value-based care. For example, pediatric dentistry may help prevent childhood obesity. HRSA has a funding opportunity for those that have and are interested in growing their dentistry program. Eligible applicants are: Programs of general, pediatric, or public health dentistry in public or private nonprofit dental or dental hygiene schools Approved residency in general, pediatric or public health dentistry Advanced education programs in the practice of general, pediatric or public health dentistry HRSA expects to provide grant recipients about $100,000.00. The deadline for this grant is Monday, April 19, 2021.

Dentistry is a key service to offer patients of all ages. Whether it's general dentistry or a specialty dentistry service that your patient base requires, it is a key component to good overall health. We can help you partner with local dentistry providers to treat your pediatric, adolescent and adult patients.

From the Hill and other useful info

The National Institute of Mental Health (NIMH) is seeking to improve the mental health of those that reside in rural areas and is requesting information. NIMH is seeking “input on how [it] might learn about and remedy research gaps in knowledge to address mental health disparities in rural people and communities. NIMH, Office for Disparities and Workforce Diversity and the Office of Rural Mental Health Research promotes innovative research that can address mental health issues facing rural residents and communities.” The following research ideas and information is being requested: Identifying the gap areas that can be addressed through research Endorsing specific research topics and questions Proposing new avenues to address with research Novel hypotheses on any of the questions, as well as specific suggestions for approaches to answering any of the questions Exploring how the research topics might intersect with and impact diverse populations, to include for example race and ethnicity, culture (including mountain and frontier), immigration status, and sexual and gender minorities, as well as additional challenges faced by rural residents. Responses are due by Thursday, April 15, 2021 to be considered. Xavier Becerra was confirmed as the HHS secretary under the Biden Administration. “HHS will help facilitate [COVID-19] vaccinations and testing efforts as health officials hope widespread inoculation will beat a mutating virus and allow businesses and schools to reopen.”

Last newsletter touched on the elderly and COVID-19 vaccines. An updated Kaiser Family Foundation (KFF) analysis has found that 22 states and Washington DC has vaccinated at least one-third of their 65 and older residents against COVID-19. While this is quite an accomplishment, no states have surpassed vaccinating 50 percent of their population. This is displayed in the figure above this paragraph. President Biden has promised that there will be enough COVID-19 vaccines to vaccinate those that want to receive the vaccine by June 1, 2021. Vaccinators are looking to get all the possible vaccines out of the vials - if regulators allow. The American Society of Health-System Pharmacists asked the Food and Drug Administration (FDA) to consider pooling left-over vaccines from multiple vials to get a full dose in an effort to vaccinate more people. Federal health regulators are opposed to this solution because “from 1998 to 2014 more than 50 outbreaks of viral or [bacterial] disease were reported as a result of unsafe injection practices, including injecting multiple patients with a drug from the same vial. The FDA’S current policy [is] that ‘doses [are] not [to] be pooled from different vaccine vials, especially for coronavirus vaccines, which are not formulated with a preservative.’ [The CDC’s website] explicitly tells vaccinators to discard vials ‘when there is not enough vaccine to obtain a complete dose.’”

HRSA UPDATES HRSA has several funding opportunities available. Click here to explore all the available grants.

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