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Community Health Center (CHC) Encounter Rates

October 21, 2013

How much do you make per visit? Seems simple. Next… how much does it cost you to see a patient? Hopefully less than you make. So much is made of KPI but in the end taking a look at something as simple as determining whether you make money on a per visit basis is an important place to start.

Simply take the total amount of money your CHC was paid and divide it by the number of patient visits it took to make that much money, for example $100,000 in payment for seeing 1,000 patients = $100 payment per visit, your encounter rate.

Actually, most CHCs just want to minimize how much they lose per visit. Without grants, a profit per visit seems unattainable. But is it? What happens if funding on which you depend just disappears? Not possible, how about universal health care? If we pay for that, what happens to 330 funding, Title X, Ryan White and other federal/state funded programs created to cover the uninsured… who are now insured…

We were asked to create a training for a group and the working title was “No Funding, Now What?!? What’s your CHC’s plan? Start with that measurement per visit across the entire CHC.

How about per clinic? Per provider? Per payer?

With this data, you can make better decisions about where to focus billing staff’s time and energy. AND, take a look at PMG’s chart below showing the average payment in your state. Are you above the rate?? Good for you… below? How can you improve!!

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