Why Billing is Necessary
Embracing the need to expand revenue streams through insurance documentation and billing programs.
Solve your funding crisis by starting or improving a billing program.
The recessionary forces at play in the US (and globally) from 2008 forward have had a significant impact on the viability of public sector health programs. Although the medical sector has continued to show real growth in both services and revenue, public health programs have been in severe decline. The contributing factors for this decline are primarily associated with state and municipal tax revenue declines and the requirements that these entities maintain a balanced budget. This requires very difficult policy and budget choices for both legislators and executives. Since most state and local public health programs are funded through tax-funded appropriations, they are particularly vulnerable to reductions. These programs must compete with fire and public safety entities for appropriations and are less visible and appreciated by the general public. As a result, they have often been more proportionately reduced than other funding needs in the public sector.
One public health organization facing a similar challenge was the Indian Health Service (IHS). Within the Department of Health and Human Services, the IHS is responsible for providing federal health services to American Indians and Alaska Natives. The agency provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 564 federally recognized tribes in 35 states.
Dr. Craig Vanderwagen, former Assistant Secretary for Preparedness and Response, was the Chief Medical Officer for the IHS when he implemented the revenue generation program. He recalls that the IHS found itself unable to meet many of the health and medical needs of its beneficiaries when it solely relied on appropriated budgets to fund its activities. It embraced the need to expand its revenue streams through documenting and billing insurance programs. Dr. Vanderwagen stated:
The lessons from Indian Health are many. The broader lesson learned is that a public health agency with a clear mission to improve health can implement a robust revenue generation program which enhances its ability to meet its health mission. The act of focusing on revenue generation through billing is no more distracting than chasing grant funds. Indeed, if electronic systems are used that link to a patient health record, the process is quite efficient in generating revenue without significant expansion of cost to generate that revenue
Read Dr. Craig Vanderwagen's whitepaper, The Importance of Revenue Generation in Public Health Programs: A Brief History of an Organization's Experience to learn how a large public health organization overcame funding issues by implementing a revenue generation program.