Revenue and the Road to Health Equity
By SMART Health Claims
The state of health inequity in our country today is at its highest point in decades
At this year’s NACCHO Annual conference, the largest gathering of local health officials, public health authorities will focus on one of the biggest issues facing our nation - health equity. Featured as a regular topic on this blog, we believe the state of health inequity is perhaps at its highest point since the Great Depression.
A report by America’s Health Rankings released earlier this year exposes many health inequities that exist today in the area of prevention. The report found enormous disparities in access to healthcare providers by income, education, geography, race, and ethnicity.
A Few Findings from America’s Health Rankings Spotlight: Prevention report
59% of Hispanic adults have a dedicated health care provider, compared with 77% of blacks and 82% of whites.
68% of adults without a high school diploma have a dedicated health care provider, compared with 80% with a high school degree, and 85.0% of college graduates.
72% of adult males have a dedicated health care provider, compared with 82% of females.
The Root of Health Inequity
Perhaps the greatest contributing factor to inequity in public health today is funding. Headlines from across the nation reveal the desperate financial state of many state and local health departments.
In our own nationwide survey of public health professionals, we found that many local health organizations are in a constant state of financial struggle. The precipitous decline of traditional funding sources since the beginning of the recession in 2008 has created an environment of uncertainty and anxiety within local health agencies.
As public health funding declines, the disproportionate treatment of illness in America becomes even more aligned with socioeconomic status. By finding ways to increase revenue streams from within, local health departments can have the greatest impact on efforts to achieve health equity and transform their communities.
Why Billing is Essential to Health Equity
Today, nine out of ten health departments are actively billing public and private health insurance. While this alone is a significant step forward for public health as a whole, there are many opportunities to strengthen the economic infrastructure within a local health department. Setting fee schedules, establishing policies and procedures, mapping workflows, and training staff on billing coding are just a few of the steps you can take to reduce denials and create more efficient billing processes.
Of all the steps you can take, the biggest impact you can make on improving your billing program is through contracting and credentialing. This is the first and most essential step of revenue cycle management because it formalizes agreements with insurance payers so that claims are reimbursed promptly versus outright denied. It also ensures that claims are reimbursed at the proper amount, rather than at a significantly reduced price.
Successful contracting and credentialing will ultimately allow health departments to increase revenue and strengthen their efforts as public health leaders in their communities by providing essential health services to all – even those without insurance.
You can learn the secrets of contracting and credentialing with The Essential Guide to Credentialing and Contracting. This eBook presents step-by-step, how-to guidance for public health professionals to navigate the credentialing and contracting process, including the common roadblocks and everything you’ll need to successfully become credentialed.