Since their formation 45 years ago, health centers have expanded not only in numbers but in their importance to America's healthcare system. Today, with more than 1200 health centers providing care to more than 20 million Americans in 8,0001 communities, health centers provide vital services to those most in need.
J.H. Cohn understands the constantly evolving regulatory environment creates significant challenges for Community Health Centers and Federally Qualified Health Centers ("FQHC"). The professionals in our Healthcare Industry Practice have a long history supporting FQHCs. For example, they have assisted with the implementation of Medicare and Medicaid programs that increased revenue through conversion to cost-based reimbursements, and with the establishment of Prospective Payment System, or PPS, rates.
In addition, members of our Healthcare Industry Practice have worked with the National Association of Community Health Centers ("NACHC") and various state Primary Care Associations ("PCA") to evaluate the impact of health reform on the financial operations of FQHCs. Our team shares its expertise with industry executives by providing extensive training on financial and operational best practices for community health centers.
J.H. Cohn's specialists help health center clients devise innovative and tailored solutions to improve operating performance, ensure compliance with all regulatory requirements, and implement effective strategies for success in the ever-changing landscape. Our Healthcare Industry Practice helps clients:
- Evaluate the operating performance of a center and determine whether revenue enhancement, provider productivity, and/or cost containment opportunities exist;
- Address third-party reimbursement and regulatory matters including the preparation/review of Medicare and, where applicable, Medicaid cost reports and the evaluation of alternative payment methodologies resulting from ongoing health reform legislation, including Protective Payment System hold-harmless provisions;
- Strategize the center's role in health reform including participation in Accountable Care Organizations ("ACO"); Patient-Centered Medical Homes ("PCMH"); the FQHC Advanced Primary Care Practice demonstration program; and other demonstration projects issued by the Medicare-Medicaid Coordination Office and the Center for Medicare and Medicaid Innovation;
- Tackle Federal grants management by providing technical assistance with the preparation/review of regulatory reports (e.g., Uniform Data System and Federal Financial Reports) and grant applications;
- Develop and implement corporate compliance programs, assess high risk areas, and respond to Office of Inspector General and state audits and inquiries;
- Assess the opportunities and challenges presented by participation in the Federal 340b drug pricing program, including compliance with audit requirements of demonstration projects; and
- Collaborate with other providers by providing technical assistance in areas such as: participation in residency training programs and transfers of existing non-FQHC ambulatory care sites.
1. National Association of Community Health Centers