Case Study 3

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California State University, Stanislaus *

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4300

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Medicine

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Feb 20, 2024

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pdf

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4

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Case Study "Keeping the Community Health Center's Doors Open", Chapter 10. 1. What are the facts in this case? - There is a significant portion of insured patients who are underinsured. Given their low incomes, many patients purchased less costly plans through the federal and state marketplaces. - Quality Care CHC is a federally qualified health center that is located in a medically underserved area. - Population is from very low socio-economic status, medically underserved and vulnerable with high infant mortality rates and there are no adequate primary health care providers. - The mission of this CHC is to provide affordable, quality primary care services to the medically underserved population regardless of their income and insurance status, so there are many patients coming without insurance and not able to pay the very little amount charged to them after care, and as a result the center is not able to get even the service cost which the center spends for each patient. - Due to lack of funding, the center cannot offer good salaries and benefits for its employees and recruit and train clinicians and other staff, resulting in many vacancies in the CHC. 2. What are three factors contributing to the community health center’s problems? - 1) It is a non-profit, federally qualified health center located in a medically underserved area.
- 2) Population is from low income and 30% are uninsured and not able to pay the sliding fee scale that is only a fraction of cost of service provided and many insured patients are underinsured (not able to get the insurance coverage) because they have not paid their deductibles. - 3) With the available federal funding and insurance reimbursement the CHC is not able to get its cost of services provided and is at a loss. 3. What are the consequences of a community health center closure for both patients and the community? - Poor health status of the population further declines the socio-economic status of the community. - Increase in morbidity and mortality rate in the community. - Patients will not seek medical care for their health problems due to lack of finance. 4. Are there sources of revenue that the CHC hasn’t focused on, such as fundraising in the community and with foundations and corporations? - The annual federal section 330 grant provides money to pay for its cost of providing care to uninsured and underinsured patients. It also provides funds for services such as management, eligibility and enrollment services, transportation, community health worker programs and patient education. - The local and state grants are also available. - The CHC can raise funds with the help of local bodies and other foundations in the area to improve the facilities of CHC.
5. What alternative sources of care are available for community health center patients? - There are nearby private and for-profit organizations, patients who can afford can seek care from these institutions. 6. How important is the provision of enabling services for community health center patients? - Provision of enabling services is very important for community health center patients because these services help them to access and receive care in a better way. These services include transportation, translation, and interpretation services, which help patients who do not speak English or have other communication barriers to communicate effectively with their healthcare providers. Without these services, it can be difficult for patients to understand their health conditions and follow their treatment plans, which can lead to poorer health outcomes. 7. What are the consequences of patients' foregoing care? - The consequences of patients going without care can be serious and even life-threatening. Without access to healthcare, patients may delay or avoid seeking treatment for their conditions, which can lead to complications that require more extensive and expensive treatment. This can lead to higher healthcare costs and a worse overall health outcome. 8. What strategies could the executive director employ to address the health center’s financial challenges? - The executive director of a healthcare center facing financial challenges may employ several strategies to address them. One strategy is to seek out new sources of revenue,
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such as exploring partnerships with other organizations or seeking out grants or funding opportunities. - Another strategy is to reduce expenses, such as cutting back on non-essential spending or streamlining operations to reduce overhead costs. The executive director may also focus on improving the center's financial management, such as by implementing cost-control measures or improving billing and collections processes. - The executive director may advocate for policy changes at the local, state, or federal level to increase access to healthcare and increase funding for community health centers. By implementing these strategies, the executive director can help to ensure that their healthcare center remains financially stable and able to provide high-quality care to its patients. 9. What steps can the executive director take to improve the health center’s recruitment and retention rates? - The executive director can diversify funding, advocate for better reimbursements, and implement cost-efficient measures like bulk purchasing and streamlined processes to address the health center's financial challenges. - Also enhance recruitment by offering competitive compensation, engaging the community to create a sense of pride, and investing in staff development. This will foster loyalty, attract skilled professionals, and create a supportive work environment.