There are many reasons why FQHCs hire consultants to solve an issue within the organization.
It could be to write a grant application, or to address internal issues without costing a fortune. Possibly it is because that the organization has limited resources or want an unbiased opinion. Also, many organizations want advice, guidance and expertise with a new venture.
However, how do you know which consulting firm is right for you? What should you look for when seeking expert advice?
Although the right fit is highly dependent on your goal, here are six things that can help you figure out if a consulting firm is worth working with.
Track Record of Success
You should always ask about who they have worked with and how successful the project was. Some consultants may be great at pitching you, using all the buzz words that you want to hear but have no track record of success. That is why it is important to speak about the firm’s prior experiences with an issue similar to yours or with a company of your size.
Always make sure that the firms you’re talking to can refer you to past FQHCs who can confirm a successful project. Actual client references will help you determine which consulting firm can address your issue more efficiently.
Remember, there are many firms that are now calling them FQHC Consultants but with very little actual FQHC expertise.
An Experienced Team
You can learn a lot about a consulting firm based on how they pitch you as a client. The best consulting firms care about your time, and they won’t waste it by initially presenting to you with senior members of their team but using less experienced consultants to do the actual work. Whoever presents to your organization at the beginning should also be who your team actually works with in the long run.
We have seen many so-called consultants send out people that have virtually no experience in FQHCs or in business in general. What added value could these people possibly add.
Also, make sure that the experience is actually in what you are looking for. If it is Grant Writing, then don't hire a professional writer that has never written a grant for HRSA. If it is re-engineering your organization such as patient flow, don't hire a billing company.
And do not always base your decision on price. Experience and actually making sure your project comes to a positive conclusion is the first priority.
Reasonable Cost Structure
Determining a reasonable cost requires more than simply finding the cheapest company. An inexperienced consultant who is cheaper but takes a longer time to reach your goal, or in many cases do not actually meet your goal, may be more costly than an experienced consultant who reaches your goal more quickly but with higher bill rates. Whatever level of experience your consultant has, you should keep your budget in mind when speaking with different firms.
Moreover, you want to work with a company that intends to solve your issue without dragging the contract on for too long for the purpose of keeping you as a client as long as possible. Good consulting firms will propose an end date for resolving your company’s problem that doesn’t extend indefinitely. An example is that we always give a probably end date, and bill on a project basis not hourly. We also pay for our own expenses and do not pass those on to the client.
We have seen "consultants" pass on ocean front lodging, and basically their only goal is to keep billing the health center.
Depending on the type of project your organization needs, it is not always appropriate to hire a specialist. Organizations should aim to hire a well rounded consultant who has worked in other industries besides healthcare. A generalist will be able to pull from different experiences across different industries and come up with creative solutions that your business would not have been able to come up with internally. You should seek to add extra skill and value to your team, instead of simply enhancing what your team can already provide as experts in their specific fields. This has been especially useful when we have organizations that need re-engineered. The combination of specialist and generalist has been ideal and has allowed in most cases an immediate impact for the organization.
The most effective consulting firm is able to listen to their clients and communicate in an efficient manner. Make sure that the consulting firm's team pays attention to your needs and demonstrates the ability to give an honest, unbiased opinion about the issues and how to fix them. Clear and effective communication skills are imperative to making this business relationship beneficial to your company.
We are sometimes criticized for being "too honest, but that is actually the key to adding value. We meet many times with the Board, upper management and lower level employees and we make sure that we are honest and straightforward with each group. We never tell people "what they want to hear" and yet we see other consultants do that time and time again, and we see organizations that should know better accept that time and time again.
Watch out for Conflicts of Interest
We never get paid by anyone except our client. We don't promote any service or product over another. We take a real world view of our clients and want to insure transparency. It always amazes us why an organization would for example hire a billing company to do general consulting. Obviously their priority is to get their billing software in the organization and not the best interest of the organization.
We have been contacted probably by more billing and software companies than we can remember. They want us to promote their product when we are consulting. We NEVER would do that, but MANY do. Who is to say that their product or service would benefit the organization. The only surety is that if you bought it, it would benefit the consulting company.
We find this type of relationship dishonest and hope someday will stop.
With the world of FQHC consulting growing quickly, heath centers must be able to figure out how to pick the right consulting firm for them. Whatever your goals are, you must ensure that the consultant has the background and skill necessary to help you in your endeavors and meet YOUR goals, not the consulting companies.
FQHCmd invites you to contact us to discuss your project.
We have noticed on some of our "Mock" Surveys that facilities are not utilizing the latest Poverty Guidelines or have instituted them late. Please insure that your Sliding Fee Scale policy addresses this situation and that you have implemented the latest poverty guidelines correctly. The latest Poverty Guidelines that were issued on January 18th, 2018 can be found here: https://aspe.hhs.gov/poverty-guidelines
FQHCmd conducts many "Mock" surveys. The most popular reason is to get a health center ready for their OSV (Operational Site Visit) by HRSA. As we limit the number of Mock Surveys that are done, please phone or email us to schedule yours today.
Here is a breakdown of the Mock Survey.
OSV Assessment, Efficiency & Productivity Analysis ("Mock" Survey/Review)
FQHCmd is aware that HRSA is planning and executing an increased number of HRSA Operational Assessments nationwide. We have developed a 3 day intensive on-site "Mock" Survey/Review that covers all areas of that will be reviewed by HRSA as covered in the most recent Health Center Program Compliance Manual including:
The "Mock" Survey includes working with both Management and the Board and is a cost-effective, confidential review of all Program Requirements from HRSA included in the Health Center Program Compliance Manual and will review and identify all strengths and weaknesses of your organization and include recommendations for corrective actions. We will also review your productivity and efficiency with recommendations for improvement.
This Assessment is typically completed and reporting is presented the final day of the site visit with any follow up reporting provided in 7 to 10 days. This Assessment is 3 days on-site by both partners (costs included in quote). All results and recommendations are confidential and only presented to the health center management and/or board of directors.
To discuss your "Mock" Survey, please contact us at 800-546-7106
We have been receiving many inquiries about the 2017 Federal Poverty Guidelines. Here is the link from the HHS that was posted January 31st.
Needless to say, your Sliding Fee Scales should have been updated at that time. If you need Policies or Procedures relative to the Sliding Fee Scale, you can visit www.FQHCPolicies.com .
(This story previously appeared in The Hill Extra)
A little-discussed side effect of the ObamaCare repeal effort could be losing gains that community health centers — a lifeline for the nation’s most vulnerable — have made.
Republicans’ vow to gut President Obama’s signature domestic achievement has thrust all facets of the health system into uncertainty — and community health centers are no different. Nearly 25 million people receive care through the nonprofit groups, and in interviews, nearly a dozen state community health associations expressed concerns over whether advances under the law would be reversed.
“Talking points are wonderful, but we live in a reality here that talking points don't help,” Alan Pruhs, executive director of the Association for Utah Community Health, told The Hill Extra. “So we're really going to be vigilant and watching what the replacement strategies look like and how that's going to affect the populations that we’re focused on serving.”
As the nation’s largest source of comprehensive primary care for medically underserved populations, the centers are closely eyeing three major items: changes to Medicaid, a Sept. 30 fiscal cliff and the possibility of absorbing patients from Planned Parenthood
Providers at the nearly 1,400 clinics can’t, under federal law, turn patients away — even those who are uninsured — and they often provide a wide array of services, from mental health and substance use disorder treatment to dental care.
The Affordable Care Act helped these centers grow in brick-and-mortar locations and in their ability to provide services, according to the Kaiser Family Foundation, because more patients with Medicaid and private health insurance increased revenues. The health law also infused more federal funds into the programs, dollars which were extended in 2015.
Expansion of coverage and increased funding under the law helped the centers’ revenues grow from $15.9 billion in 2013 to $21 billion in 2015, according to Kaiser.
“The problem that we’re having right now, the 50,000-foot view, is the instability in the funding environment,” Jose Camacho, executive director of the Texas Association of Community Health Centers, told The Hill Extra. “You’ve got a lot of money that goes to health centers that’s on the table, and unless we're able to resolve those issues, then I think we’re going to have some problems.”
Medicaid changes are coming.
The health centers are in better fiscal shape in part because an increasing number of health center patients are insured largely due to the expansion of the federal-state program for the poor and disabled.
But it’s unclear how Medicaid expansion will fare when Republicans repeal and replace ObamaCare.
“For us, the biggest concern that we have is Medicaid,” Deb Polun, government affairs and media relations director for the Community Health Center Association of Connecticut, told The Hill Extra. “This is a huge part of how federally qualified health centers are funded and represent a huge chunk of our patients.”
At the very least, a GOP health law likely means changes to how Medicaid is financed. Republicans have been pushing two main proposals — locking states into a preset level of funds (known as a block grant) or reimbursing a state per beneficiary (called a per capita cap).
The Congressional Budget Office has estimated that recent Republican block grant proposals are likely to cut spending, according to Kaiser. Critics of the proposals say that’s sure to lead to cuts in benefits.
The proposals are hard to analyze because no legislative decisions have been made, Jonathan Watson, of the Minnesota Association of Community Health Centers, said. So he interprets the concept as less money for states, in either scenario.
“When states have less money to operate their medical assistance programs, to me, that only means cutting benefits, cutting eligibility, cutting payments to providers or asking patients for additional cost-sharing,” Watson, associate director and director of public policy, told The Hill Extra.
It might not be easy for states to make up for funding losses. Take Nebraska, for example: The state is facing a nearly $900 million shortfall over the next two years.
“So there isn’t room in our state budget right now to cover some of those needs in a Medicaid program were the federal dollars to be reduced — so it’s really kind of a double impact for us,” Amy Behnke, CEO of Health Center Association of Nebraska, told The Hill Extra.
A fiscal cliff looms.
Community health centers benefited from the Affordable Care Act in several ways, including a new trust fund for the program.
More than 70 percent of federal grant funding for health centers comes from this pot of money.
Congress extended the fund in 2015, authorizing $7.2 billion for two years, and it will hit a fiscal cliff on Sept. 30. State associations are hyper-focused on what will happen to these funds.
“That would cripple our health centers,” Jane Hayward, president and CEO of Rhode Island Health Center Association, told The Hill Extra.
And it would have a “devastating” effect on Utah, Pruhs said, adding it could lead to close to half of the state’s health centers shuttering their doors and potentially upwards of 35,000 patients losing access to care.
“I think if there's support for anything, there's probably support for continuing health centers,” Sara Rosenbaum, a George Washington University professor of law and policy, told The Hill Extra. “But there's no guarantee that they're going to have their funding continued.”
Federally qualified health centers “play a vital role” in the country’s health, the likely new head of the Department of Health and Human Services said.
“I think it’s imperative that we retain them or improve the delivery of care in that area,” Rep. Tom Price (R-Ga.) said at a Senate Finance Committee hearing on his nomination to head HHS.
The Planned Parenthood factor.
There’s another potential wrinkle — House Speaker Paul Ryan (R-Wis.) has said cuts to federal dollars for Planned Parenthood should go to community health centers instead.
“We think it's better to send these dollars to those clinics that do a very good job of giving women the services they need, the preventive services, without all the controversy surrounding Planned Parenthood,” he said recently.
But, at least in the short term, it’s not realistic that they would be able to care for the millions of patients that Planned Parenthood serves.
“There are a lot of services that are provided by Planned Parenthood that are not really that controversial,” Polun, of Connecticut, said, “and health centers do provide many of those same services, but it would be extremely difficult to take on all of those patients in one fell swoop.”
Some community health centers are no stranger to this debate.
Utah’s Republican governor, Gary Herbert, attempted to defund Planned Parenthood, raising a similar issue among centers.
At the time, the Association for Utah Community Health discussed the matter, and Pruhs said absorbing some of Planned Parenthood's patients would have taken time, Pruhs said. He added that Planned Parenthood is a referral partner and part of the healthcare safety net.
Ultimately, a federal appeals court halted the Utah governor’s effort.
Pause button on hiring, expansion.
When strategic planning came up at a recent Minnesota community health center board meeting, there were too many unknowns to make decisions.
The uncertain future is “putting, let’s say, a pause button on any significant strategic planning, capital expansions or really further integration of some services of the community health centers,” Watson said. “It’s creating a lot of angst amongst patients — patients are coming into providers saying, ‘Are you guys going to be here in a year?’”
In New York, there are about 28 job openings at Finger Lakes Community Health, which Mary Zelazny runs.
“I’m desperately trying to find people to take those jobs, and it’s hard,” Zelazny, who is also the board chair of the Community Health Care Association of New York State, told The Hill Extra. “Do I go ahead and fill those positions? Because I don’t really know if I’m going to have the funding that I have right now.”
Others echoed that sentiment.
“I think you're going to hear repetition from anybody in our world that there's a lot of concern,” Andrew Behrman, Florida Association of Community Health Centers president and CEO, told The Hill Extra, “and I think a lot of the concern is the unknown.”
Congratulations to our client Community Council Health Systems in Philadelphia. Pennsylvania was selected as one of the eight states to participate in the Certified Community Behavior Health Center (CCBHC) progam with HHS. After we successfully applied for the program, Community Council became one of only a handful of clinics in PA, and now in the country to meet the CCBHC requirements and become one of the only Certified Community Behavior Health Center's in the US.
This is a two year pilot program before it rolls out nationwide.
Jim Nixon, the CEO and his whole team were great to work with on this project and it is very exciting to be selected. Great job!
HHS selects eight states for new demonstration program to improve access to high quality behavioral health services
The U.S. Department of Health and Human Services today announced the selection of eight states for participation in a two-year Certified Community Behavioral Health Clinic (CCBHC) demonstration program designed to improve behavioral health services in their communities. This demonstration is part of a comprehensive effort to integrate behavioral health with physical health care, increase consistent use of evidence-based practices, and improve access to high quality care for people with mental and substance use disorders.
“These states and their community clinics have done an incredible job in paving the way for the demonstration program,” said Deputy Assistant Secretary for Mental Health and Substance Use Kana Enomoto. “We look forward to demonstrating that by balancing incentives and accountability, an enhanced level of accessible, comprehensive, and quality care can be provided to all Americans.”
The eight states HHS selected for this demonstration program include Minnesota, Missouri, New York, New Jersey, Nevada, Oklahoma, Oregon, and Pennsylvania. States have until July 1, 2017 to begin their two-year demonstration programs.
“The demonstration program will improve access to behavioral health services for Medicaid and CHIP beneficiaries, and will help individuals with mental and substance use disorders obtain the health care they need to maintain their health and well-being,” said Vikki Wachino, Deputy Administrator of the Centers for Medicare & Medicaid Services, and Director of the Center for Medicaid and the Children’s Health Insurance Program Services.
In 2015, HHS awarded planning grants to 24 states to support certification of community behavioral health clinics, solicit input from stakeholders, establish prospective payment systems for demonstration reimbursable services, and prepare an application to participate in the demonstration program. At the end of the planning grant year, 19 States submitted applications to participate in the demonstration program. The applications were reviewed by subject matter experts from the Substance Abuse and Mental Health Services Administration, CMS, and Office of the Assistant Secretary of Planning and Evaluation for strengths and weaknesses. A key consideration in their selection was that participating states represented a diverse selection of geographic areas, including rural and underserved areas.
Under the program, selected states will be reimbursed through Medicaid for behavioral health treatment, services, and supports to Medicaid-eligible beneficiaries using an approved prospective payment system. To qualify for certification, CCBHCs provide core services across the lifespan, utilize evidence-based practices and health information technology, report on quality measures, and coordinate care with primary care providers and hospitals in the community. Populations to be served are adults with serious mental illness, children with serious emotional disturbance, and those with long term and serious substance use disorders, as well as others with mental illness and substance use disorders. The demonstration program reflects a broader Administration-wide strategy to create a health care system that results in better care, smarter spending, and healthier people.
The selected states’ demonstration programs will be evaluated based on data from 21 quality measures collected through sources such as program records, Medicaid claims, managed care encounter data, and clinic cost reports. Qualitative data also will be obtained from interviews with state officials and clinic staff. HHS will report on the access, quality and financial performance of the demonstration programs annually beginning December 2017, using data from the evaluation.
Authorized under Section 223 of the Protecting Access to Medicare Act of 2014, this demonstration program is a combined effort by several HHS agencies including SAMHSA, CMS, and the Office of the Assistant Secretary of Planning and Evaluation.
For more information on the Section 223 Demonstration Program for
CCBHCs visit: http://www.samhsa.gov/section-223
Department of Health and Human Services awards over $50 Million for new health center sitesToday, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced over $50 million in funding for 75 health centers in 23 states, Puerto Rico and the Federated State of Micronesia.
“We expect this competitive New Access Point funding to provide health care to more than 240,000 additional patients, ” said Dr. Mary Wakefield, Acting Deputy Secretary at HHS. “These new health center sites will contribute significantly to the health of families and communities across the nation.”
Health centers are community-based and patient-directed organizations that deliver comprehensive, culturally competent, high-quality primary health care services. Health centers also often integrate access to pharmacy, mental health, substance abuse and oral health services in areas where economic, geographic or cultural barriers limit access to affordable health care services.
“For millions of Americans, including some of the most vulnerable individuals and families, health centers are the essential medical home where they find services that promote health and diagnose and treat disease and disability,” said Health Resources and Services Administration (HRSA) Acting Administrator Jim Macrae. “One in 13 people nationwide rely on a HRSA-funded health center for their preventive and primary health care needs.”
Nearly 1,400 health centers operating over 9,800 sites provide care to more than 24 million people across the nation, in every U.S. state, the District of Columbia, Puerto Rico, the U.S. Virgin Islands and the Pacific Basin. Today, health centers employ nearly 190,000 people.
For more information on these awards, visit https://bphc.hrsa.gov/programopportunities/fundingopportunities/newaccesspoints/fy2017awards/index.html
Congratulations to CEO Laurie Asbury and the entire team at the Northeast Florida Health Services in Pierson, FL for being awarded an New Access Point grant for FY 2017. Great job!
To view all award winners click here
Congratulations to our client the Great Salt Plains Health Center in Cherokee, Oklahoma for being awarded a New Access Point grant. FQHCmd is very happy for the CEO, Tim Starkey and the entire Great Salt Plains staff.
To view all award winners click here
About the FQHCmd Consulting Group
FQHCmd Consulting Group is a nationwide consulting group for FQHC, FQHC Look Alikes, Rural and Community Health Centers.