PRIORITY #4: HEALTHCARE FINANCING |
| Improve
health care financing in order to avoid loss of
revenue from Medicaid, to finance medications
and indigent health care, and to increase reimbursements
to the Clinic. |
|
| GOAL
I |
Become
an authorized provider of health care plans that serve
Galveston County residents. |
| Activities: |
- Identify barriers in health care plan designations.
- Initiate a contract with HMO’s, PCP’s,
the Veterans Administration, Medicaid and Medicare.
|
| GOAL
II |
Assure
that all patients who are potentially eligible for health
insurance are provided the opportunity to apply for coverage.
(See Priority 7, Goal V). |
| Activities: |
- Develop a process to identify these clients.
- Identify barriers in the health care eligibility
systems that could be remedied.
- Train staff on standardized information regarding
health insurance related procedures.
|
| GOAL
III |
Assure
4C’s Clinic fees are appropriate and reflect the
actual cost of service. |
| Activities: |
- Ensure fees charged cover expenses and are appropriate
for the market.
- Bring recommendations to the Governing Board.
|
| GOAL
IV
|
Increase
collection of fees charged to self pay patients (for example,
uninsured) so they meet national standards set by the
Centers for Medicare and Medicaid Services (CMS).
|
| Activities: |
- Develop a patient education program to assure patients
understand their rights and responsibilities.
|
| GOAL
V |
Assure
coding accurately reflects the services provided and
diagnosis made. |
| Activities: |
- Identify common coding errors.
- Clarify responsibilities for diagnosing and coding.
- Implement a training program for appropriate providers
and staff.
|
| GOAL
VI |
Increase
the proportion of clinic patients who have third party
reimbursement.
|
| Activities: |
- Review contracts with medical specialists to assure
clinic patients return to their medical home.
- Implement a marketing program to attract more patients
with third party reimbursement.
- Implement measures to strengthen the clinics capacity
to delivery comprehensive ambulatory health care services
to such patients.
|
| GOAL
VII |
Work
with community partners and the Legislature to develop
a funding method that would support indigent health
care.
|
| Activities: |
- Form a joint committee of both boards to develop
a unified position regarding indigent health.
- Develop an advocacy plan.
|
| GOAL
VIII |
Review
and assure that the pharmacy formulary and laboratory
authorized tests are consistent with the clinic practice
guidelines. (See Priority 5, Goal
I).
|
| Activities: |
- Develop clinic practice guidelines.
- Evaluate current provider practice in ordering
tests for common presenting symptoms.
- Analyze lab testing cost data.
|
| GOAL
IX |
Implement
a Perpetual Pharmacy Inventory System as a fiscal monitoring
tool. (See Priority 3, Goal
III).
|
| Activities: |
- Develop clinic practice guidelines.
- Analyze practices in prescribing medications.
- Analyze drug prescribing cost data.
|
