Community Health Centers (CHCs) increase access to primary care services for communities by reducing common barriers such as cost and lack of health insurance. In spite of the excellent care they deliver, these critical providers often need outside resources to help them operate their businesses effectively so they can continue their mission to serve, remain solvent, and act as good stewards of the funds with which they are entrusted.
These days, CHCs must find seriously innovative ways to deliver comprehensive care services while keeping a close eye on budgets. That’s a tall order. In fact, 91 percent of people served by CHCs are low-income individuals, and 81 percent are uninsured or enrolled in Medicare or Medicaid. This is where Monarch Health Solutions excels.
Under the expert leadership of Don McDaniel, CEO, Monarch Health Solutions delivers advisory services and other hands-on solutions specifically built to help all types of CHCs, including the nation’s nearly 1,400 Federally Qualified Health Centers (FQHCs).
Driving CHC Performance
Monarch has created a revenue cycle management service uniquely designed to drive better performance for CHCs. It is a framework that ensures the end-to-end financial process is sound and able to run smoothly. Canton & Company, with its broad experience delivering business transformation and strategic solutions for the full landscape of healthcare organizations, amplifies the impact of the framework.
Monarch delivers a big-picture strategy and a plan of action that is both realistic and oriented toward long-term sustainability. That’s incredibly important considering that CHCs operate on margins of about three percent at the best of times, with many enduring financial losses recently because of the pandemic.
Monarch provides CHCs proprietary market research then translates that knowledge into practical plans that produce results. It also offers integrated growth solutions so health centers can grow alongside their communities. For example, a center might need comprehensive marketing to engage and gain new patients, a better way to manage its specialist network or advanced skills in negotiating with health plans. Monarch believes sustainability in the new health economy should not be about doing more with less. It’s about doing more with insight.
Monarch often reminds CHCs that value-based payment models are inevitable. Although it’s difficult to plan for the future when you’re just trying to make it through the day, CHCs must assess their readiness and their market positions. Monarch is acutely aware of that challenge. That’s why its services meet CHCs where they’re at. From solving for immediate talent recruiting and operational needs to taking on financial risk and negotiating contracts for value-based payment, the company can help them thrive today and tomorrow.
As the CEO of Canton & Company and Monarch Health Solutions, McDaniel is passionate about retooling the healthcare market so it functions rationally and puts the consumer at the center of every interaction. McDaniel is a former hospital, health-services, technology, and insurance industry executive. He also has launched several healthcare businesses and served as an operating partner for a venture capital firm. Consistent across his diverse background is helping healthcare companies of all sizes and stages succeed through strategic growth.
An inspired entrepreneur, McDaniel is also an active board member, executive advisor, investor, and fund-raiser. He is a recognized thought leader and health economist who won’t shy away from constructing major turnarounds for distressed and challenged businesses, including medical groups, managed care, revenue cycle management, value-based care networks, health information technology firms, and medical device firms, among others.
Participating in many health policy and regulatory initiatives, McDaniel has acted as a commissioner for Maryland’s 1115 Waiver Advisory Group, advised Maryland’s Governor and Health Secretary on securing an 1115 Waiver, and advised a pre-eminent, Sovereign Indian Nation in launching the Nation’s first Indian Medicaid Managed Care Entity.
A Comprehensive Suite of Growth Services
Monarch’s growth services are purpose built for CHCs:
- Analytics and Insights: These services range from data analysis and benchmarking to compensation design and strategic plans for new-patient acquisition. Everything is driven by its proprietary data and data science that translates information into insight.
- Managed Services: CHCs can outsource a great deal of their heavy lifting to Monarch. The company manages pharmacy services, tech platforms, marketing, recruiting, human resources, finance, and more. That allows the CHC to focus on patient care while the Monarch team takes care of the operational details of running the business.
- Performance and Growth: CHCs must become more sophisticated to thrive in today’s environment. That means operating under complex value-based payment models, transforming workflows for efficiency, and optimizing every line of business to serve the community effectively. Monarch helps them grow in the context of the market.
- Revenue Cycle Management: CHCs need to maximize the reimbursements they get from payers, reduce payment delays, and streamline their entire financial workflow. Monarch’s RCM services foster transformational work that results in higher margins and greater efficiencies. The important mission of CHCs should never be encumbered by RCM hassles or ineffective workarounds. Monarch solves for those challenges.
Toward a Sustainable Future
Running a health center has always been hard work, but that’s especially true now with the growing needs among CHC communities. The population is aging, and chronic disease is on the rise; therefore, more people need more healthcare services. On top of that, the pandemic added extreme financial strain to CHCs as they worked with larger public health resources to offer vaccines and testing. And that’s just the immediate challenge. For CHCs to survive in the future, they need dramatically different financial structures and precise revenue cycle management. Why? Because the whole healthcare system is transforming from a “sick care” payment model that reimburses providers for the volume of services they deliver to one that pays essentially per patient, with the expectation of value.
That means the provider must focus on high-value services that make the patient healthier overall. This shift from volume to value requires CHCs to manage funds in a far more proactive way while also streamlining operations toward great efficiency.
Business transformation is what Monarch does best. Its services are hands-on engagements with a team of business and CHC experts who have intimate experience with what it takes to advance both the mission and the margin of CHCs against this new value-driven landscape. Its services ensure that CHCs can thrive in the emerging health economy so they can be sustainable and continue to serve their communities. That might mean ambitious strategic planning, reconfiguring the technology backbone, or even comprehensive marketing so the CHC can increase the awareness of its offerings, just to name a few.
In 2020, nearly 2,000 health centers closed temporarily, and in some cases, permanently, and Monarch believes, ‘that’s a tragedy.’
When centers close, moms and dads, children, grandparents, and people who are sick and suffering can’t get the care they need. Monarch is on a mission to make sure that every CHC in America is viable and thriving. CHCs are genuinely too important to fail.
Words of Wisdom
As advice for the aspirants willing to venture as growth and innovative service providers in the healthcare market, Don McDaniel said, “There are so many absurdities in the $4 trillion healthcare industry. It doesn’t behave like a market at all. Anyone looking to enter this space must know that the economic levers are skewed, and they need deep insight and data to make decisions rather than just trusting their gut. It’s unlike any other business segment.”
Embracing the Future Roadmap
Often, the lack of staff or skills is what slows progress for CHCs. Without performance-focused innovation, health centers lose their relevance. For example, CHCs need to offer virtual health options to keep up with what their communities need and want. Those that do not keep pace with the health-at-home movement will see their patient numbers decrease, leading to reduced funding and revenue, leading to insolvency.
McDaniel notes that innovation is the only way CHCs can thrive in the future. Monarch Health Solutions powers health centers’ success with strategic solutions designed for their unique place in the healthcare market.