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Component 1.2

Affordability/Cost

Strategies

  • Consider using non-financial techniques to maximize fee collection and minimize barriers to patients.
    • Examples include focusing staff efforts on properly assigning patients for a sliding fee and other reimbursement programs, designing procedures to collect at the time of the service, and forgoing use of mailed statements and collection agencies for sliding fee patients
  • Contract with local Coordinated Care Organizations (CCOs) to maximize Medicaid billing and reimbursement capabilities.
  • Request that uninsured patients make some payment on day of visit, but do not deny access to care.
  • If located along state borders, consider enrolling in the other state’s Medicaid program.1
    • For Medicaid beneficiaries in underserved areas of the state, this increases patient access to providers.1
  • Develop a policy and system to identify and enroll patients who are eligible for a sliding fee scale discount.
    • To appropriately apply the discount, perform a cost analysis/assessment to determine the cost of providing services.
  • Hire dedicated outreach and enrollment assistance staff to seek out and engage uninsured individuals and assist them with enrolling in health care coverage.2
  • Consider finding outside grants and resources or internal mechanisms to ensure all women get the contraceptives they need at each visit.3

Resources

  1. Families USA Policy Brief: Interstate Medicaid Billing Problems: Helping Medicaid Beneficiaries Who Get Care Out of State: http://familiesusa.org/product/interstate-medicaid-billing-problems-helping-medicaid-beneficiaries-who-get-care-out-state
  2. Enroll America, Best Practices in Outreach and Enrollment for Health Centers: https://www.enrollamerica.org/research-maps/ publications/best-practices-in-outreach-and-enrollment-forhealth-centers
  3. Patient-assistance program for purchasing Skyla and Mirena IUDs, ARCH Foundation: http://www.archpatientassistance.com