When assessing your health center’s performance, HRSA wants to see how well you’ve been conducting patient outreach. Specifically, they hope to see that your efforts have resulted in more eligible patients enrolling in Medicaid or other insurance options. If your health center is in a Medicaid expansion state, this should indeed be the case. After all, it is basically a win-win-win: a win for you, for your patients, and for the feds.
Of course, getting to that point is a little harder, and requires some work.
In the years since the Affordable Healthcare Act (ACA), many health centers have been able to lower their self-pay/uninsured patient mix to less than 10% of the total patient population. So if you’re in a Medicaid expansion state and your uninsured rate is still above 10%, you may need to examine your systems.
Here’s what you need to do so you can meet HRSA’s expectations and lower the uninsured rate at your health center:
- Track the uninsured rate regularly and produce reports.
If you’re not paying careful attention to the uninsured rate, it’s likely that the number of uninsured patients will increase. Someone at the health center should assume primary responsibility for tracking this metric. At regularly scheduled intervals, they should provide updates to the Board of Directors and other critical decision-makers.
Whenever the number starts to rise above 10%, that’s cause for alarm.
- Build outreach and enrollment into your systems.
Many FQHCs have received federal funds to build outreach and enrollment services into their systems. If you are one of those programs, you are required to submit quarterly progress reports on this program.
HRSA expects that you will provide Eligibility Assistance Services as well. This is, in fact, a statutory requirement for FQHCs, so it most definitely is not optional.
Eligibility Assistance Services help patients learn more about the federal, state, and local programs they may qualify for, which offer financial assistance for healthcare and other critical social programs. This includes Medicaid, but also veteran’s benefits, the Special Supplements Nutrition Assistance program, and legal assistance.
You have a few options for how you provide these services:
- Directly provide services
- Services can be provided on your behalf via a formal written agreement
- Provide services to patients through a written referral agreement
Regardless of which option your health center uses, you need to document your service arrangements thoroughly so that HRSA knows they’re available to your patients. As usual, the more documentation you can produce, the better.
Although the administrative requirements may be a little on the burdensome side, outreach and enrollment services are critical for ensuring that patients can access healthcare services. The time you invest in these services are well worth it.
For more advice on how to fulfill HRSA requirements, follow RegLantern on Twitter. We’re here to simplify the maze of red tape for you.