Updates from your ACE team
Expand your practice to achieve financial independence
As we finish the first quarter of 2019 (already!), we wanted to focus on revenue opportunities that enable you to capture 'low-hanging fruit' without significant resource commitment.

Over the past few months, we've discussed how to seek retroactive reimbursement for your self-pay billing claims rather than just writing them off, and we've been seeing great results so far. Read our flyer and contact us to find out how this could improve your bottom line!

In our last issue, we looked at some statistics in The Community Health Center Chartbook is sued by the National Association of Community Health Centers (NACHC) reinforcing that the way of the future for health centers lies in value-based healthcare. This month we take a closer look at the relationship between value-based care and quality measures, since these measures can generate additional revenue as well as impact managed care patient allocation by payers.

We also look at NACHC's activities on Capitol Hill this week which will impact all health centers, and provide updates from both HRSA and CMS. Hope you find this information useful!
Value-based care and quality measures - the way of the future!
Quality healthcare is a high priority for the everyone in the industry, and CMS and commercial payers are transitioning to a value-based approach that pays (and rewards) providers and facilities for improving overall patient health and reducing the impacts of long term chronic disease.

This approach requires providers/facilities to quantify the quality of care given to a patient by providing specific data for each encounter using coding (CPT, DX, HCC and RxHCC codes) and HEDIS quality measures at time of claim submission.

The data is then used by payers to get a full picture of the patient and treatment plan when enables them to determine a risk score for each patient and identify those with serious or chronic illness who are expected to incur greater medical cost. This is especially important for managed care plans, since this directly impacts the amount allocated per patient.

Payers reward facilities that provide detailed patient data and quality measures through higher reimbursement and opportunity to generate new revenue streams through pay-for-performance (P4P), star ratings and bonuses. Conversely, payers will penalize facilities who do not provide adequate quality measures by reducing payments, lowering star ratings or even potentially removing insurer-allocated patients or cancelling contracts.

Are you ready to take advantage of the revenue opportunities that quality measures can offer for minimal effort? Don't wait to the last minute!!
NACHC updates - policy, research and funding
Community Health Center leaders brief Capitol Hill

Last month, NACHC updated its Community Health Center Chartbook which provides an excellent reference on the health center program and the role of FQHCs in healthcare.

At its annual Policy and Issues Forum that started this week, NACHC will be unveiling a new policy agenda and has issued a policy brief documenting health centers' success to date in improving community health care and implementing innovations such as telehealth to increase the scope of services offered.

Community health center leaders from around the country are also meeting with members of Congress at a special briefing entitled "Health Centers - Addressing America's Health Care Needs" to discuss future policy and funding requirements. See NACHC website for full details.
2019 Policy and Issues Forum
The NACHC 2019 Policy and Issues Forum (P&I) kicks off this week (March 27 – 31) in Washington, DC. 

A key areas of focus will be long-term and stable funding for health centers as they respond to critical public health challenges, including the opioid epidemic, and care for 28 million people, or 1 in 12 Americans.

For a detailed schedule of events   please visit the website.
Annual award nominations
NACHC is currently seeking nominations for their annual Community Health Care Awards of Excellence.

Do you know a board member, clinician, administrator or public official whose accomplishments exemplify excellence in community health care and contribution to the health center mission?

Visit the NACHC website for more details - nomination deadline is Friday, April 26.
Media watch and other useful info
CMS: clarifying supervision requirements

In both the 2018 and 2019 Medicare Physician Fee Schedules, CMS made changes to include technology-based or remote evaluation services and updated rules relating to Chronic Care Management (CCM) and other services allowing auxiliary personnel to provide services under general supervision of the FQHC practitioner (as opposed to direct supervision). For more details of these changes, refer to the fact sheets in the resources section on our website .

In the same vein, CMS issued a technical correction this month allowing remote patient monitoring under CPT code 99457 to be furnished by auxiliary personnel "Incident to" the billing practitioner's professional services. This means the service is performed under physician supervision (broadly defined).

These recent changes highlight the focus CMS is placing on modernization and aligning rules and process with common practices.
Read the latest 340B OPA Program Update which provides additional information about the 340B Hospital Classification Program.

Stay up to date with HRSA's latest news.