Title
Evaluation of Sliding Fee Discount Schedules for Medical, Behavioral Health and Dental Services - Riley
Body
One of the core components for the Federally Qualified Health Center (FQHC) program is the sliding fee discount schedule. The goal of the discount schedules is to provide services to patients at reduced cost while also balancing the FQHC’s need to cover the cost of providing the service.
The Health Resources and Services Administration (HRSA) requires all FQHCs to evaluate their sliding fee scales at least once every three years. The evaluation should look at whether the discount schedule and charged fees are appropriate for the client population.
Lake County Health Department and Community health Center (LCHD/CHC) staff specifically looked at the medical, behavioral health and dental services sliding fee discount schedule. The collection rate was looked at as a means of evaluation as well as a market survey. No patient is turned away from LCHD/CHC based on inability to pay so a higher collection rate suggests that the fee is more affordable for our patients.
The attached table shows that collection rates for medical, behavioral health and dental services have decreased compared to FY19. The majority of the 2020 and 2021 data is not comparable to 2019 primarily because the FQHC has been operating in an environment of increased telehealth, and because dental services were limited to reduce the risk of COVID-19 exposure. As a result, patients are not coming into the office as often to bring in their sliding fee information. To help address that, our fee policy was temporarily modified to give patients 90 days post pandemic to apply for a reduced fee.
The market search data of other providers, per the attached table, determined that the LCHD/CHC nominal charge is similar to other comparative health centers, but dental services are slightly lower.
In May 2021, the FQHC Governing Council Task Force was re-activated to further analyze collections efforts and nominal charges. Upon review of the attached data the Task Force members are recommending no changes to the existing sliding fee discount schedules. As part of the discussion, they requested additional information on system capability for same day payment discounts, data on multiple visits by type by the same patient in a 30-day period, payment data after a patient receives a statement, and training for patients on how to navigate the patient portal. The Task Force requested that this information be provided by the end of the fiscal year for additional analysis and discussion.
Suggested Motion
To approve the recommendation of the Governing Council Task Force that no changes be made to the existing sliding fee discount schedules.