This story is part of our Post Insight – Health Care Strategies 2013 package. Click here for more.
Since 1976, United Neighborhood Health Services has provided medical care through a network of primary care clinics without regard to a patient’s income or insurance status.
And just like so many other health care entities in the state, United Neighborhood is feeling the effects of the Affordable Care Act and its compliance provisions that affect payments. United Neighborhood CEO Mary Bufwack estimates some 55,000 uninsured Middle Tennesseans will enter the health insurance market and — perhaps for the first time — gain access to health care because of the passage of the health reform package. These Middle Tennesseans will get their coverage by way of the Medicaid expansion set for 2014 or by purchasing their own coverage through the state’s planned health insurance exchange.
Their status change will affect Bufwack’s finances, since more than 50 percent of UNHS’ services are provided to uninsured patients — specifically people 18 to 30 years old. But Bufwack isn’t sitting on her heels waiting for the state exchange to kick in. While her 120-person staff is staying busy treating more than 30,000 folks at UNHS’ 18 facilities, she has spent big in recent months to upgrade her team’s computer systems and facilities to better meet ACA expectations.
The electronic health records program UNHS is installing comes with a big tab. Bufwack said it cost $200,000 just to obtain the license, or “open the box,” as she put it. Alongside the EHR system, UNHS also is investing in hardware and software, installing new data lines, hiring staff and bringing on contractors to monitor the compliance with the various provisions of the ACA.
The payoff is promising, though: Within the next few months, United Neighborhood will operate 95 percent paperless. The investments should bring it into good standing with the critical “meaningful use” mandate, a Centers for Medicare & Medicaid Services initiative that ties reimbursement dollars to an organization’s adoption of information technology.
The upgrades also will let UNHS provide better care at a manageable cost — something that will endear the organization to insurers.
“We want to make ourselves as attractive as possible to insurance companies and be seen as a provider of choice for folks,” Bufwack said. “Good outcomes equal good contracts.”