Public
Healthcare

Revenue Cycle
and Billing

Healthcare is a major focus of President Biden’s proposed $6 trillion budget for Fiscal Year 2022. The funding request includes a 23.4% increase in the Department of Health and Human Services’ budget, raising it to 133.7 billion. Numerous other agencies and programs are also included in the proposed funding, which focuses on infrastructure, crisis response, and initiatives like fighting the HIV and opioid epidemics in the United States. The budget would also expand mental healthcare access, target gender-based violence, promote health equity, and reduce maternal mortality rates—all of which will also foster public health infrastructure and meet crisis-related needs (Office of Management and Budget).

Here’s a high level overview of the President’s proposed budget:

Improving Health Infrastructure

Much of the proposed 8.7 billion in discretionary funding earmarked for the Centers for Disease Control and Prevention (CDC) would go directly to states, counties, and territories to:

  • Improve capacity
  • Hire and train new epidemiologists and other public health experts
  • Modernize public health data collection
  • Prepare for emerging health threats across the globe

Social Determinants of Health

The CDC’s Social Determinants of Health program would receive $152 million to administer grants that states and territories would use to improve health equity and data collection efforts for racial and ethnic populations. This represents an increase of $150 million over last year’s budget.

Other health equity program funding proposals include: 

  • $2.2 billion for Indian Health Service investments in community health centers
  • $200+ million to reduce maternal mortality and morbidity nationwide, especially among Blacks; support Maternal Mortality Review Committees; place early childhood development experts in pediatrician’s offices in cities with high percentages of Medicaid and Children’s Health Insurance Program participants; and create pregnancy medical home programs in each state

Establishing the Advanced Research Projects Agency for Health

The National Institutes of Health (NIH) would receive $51 billion in funding; $6.5 billion of that budget would be used to create a new research arm, the Advanced Research Projects Agency for Health. The Agency would initially focus on cancer, diabetes, Alzheimer’s, and other diseases.

Block Grants for Community Mental Health Services

The proposed budget calls for $1.6 billion for the Community Mental Health Services Block Grant program, a $800 million increase over FY 2021 enacted levels.

The Department of Veterans Affairs

A budget of $113.1 billion is requested for the Department of Veterans Affairs, which is 8.2% more than they received in FY 2021. A few of the proposed initiatives include:

  • $542 million to fund existing suicide prevention outreach 
  • $500 million to fund new suicide prevention, homelessness, and other health programs targeting veterans 
  • $40.3 million in new funding to hire 334 benefits claims staff to process Agent Orange disability compensation claims

Healthcare Policy Provisions

The president’s proposed budget contains some policy provisions, but does not include cost information. One of those provisions calls for the creation of a public healthcare insurance option through the Affordable Care Act (ACA) marketplace. Another is the creation of a $0-premium federal public healthcare option for states that did not expand their Medicaid programs. 

Fighting the Opioid Epidemic

The president requested $10.7 million to help states and territories fight the opioid epidemic. Funds could be used to increase the number of behavioral health workers, improve access to treatment, and conduct research.

HIV/AIDS Initiatives

The proposed budget calls for $670 million to reduce new HIV cases, expand access to treatment, and ensure equitable access to services and support. The funding will be divided among the CDC, the Health Resources and Services Administration (HRSA), the Indian Health Services, and the National Institutes of Health (NIH).The HIV.gov website provides a breakdown of how the proposed funding will be used to end the HIV epidemic; the amounts are in million of dollars:

ProgramAmount
CDC-support to 57 focus jurisdictions$275.00
HRSA-Health Centers$152.00
HRSA-Ryan White HIV/AIDS Program$190.00
IHS-HIV/HCV Activities$27.00
NIH-Implementation Research$26.00
TOTAL Funding to End the HIV Epidemic Initiative$670.00

American Exchange Can Help You Get Ready for FY 2022

Now is the time for community-based organizations and health departments to clear up outstanding issues and start thinking strategically about how to put FY 2022 funding to use to deliver the most value to your clients. American Exchange can help you:

  • Perform an audit of your revenue cycle management services, from intake/eligibility to collections. 
  • Clear billing backlogs, especially COVID-19 vaccination claims.
  • Increase revenue using insurance discovery tools to identify coverage for patients who did not provide insurance information at the time of service. 
  • Identify other revenue streams missed in 2021.    

Here are are few of our success stories:

  • We cleared a backlog of 40,000 cases in four (4) months for a county health department:
    • We recouped $150,000 in one (1) month
  • We filed 250,000 vaccine administration claims in three (3) weeks for a state client:
    • Reimbursements began arriving within seven (7) days.
  • We achieved a 56% success rate on accounts where no insurance was listed
    • We delivered more than 30 times return on investment (ROI) on those accounts.   
    • For patients who had insurance listed, we achieved a 75% confirmed coverage rate

American Exchange Can Handle All Your Revenue Cycle Management Needs

American Exchange’s revenue cycle management experts can increase the efficiency of your entire process while decreasing reimbursement time frames with a complete suite of services. We specialize in providing white glove services to public health and Ryan White programs throughout the US. We offer the following services to improve your cash flow and make your practice or organization more sustainable.

  • Revenue Cycle Management
  • Intake and enrollments
  • Credentialing
  • Medical Billing and Coding
  • Insurance Discovery
  • Accounts Receivable Management
  • Denials Management
  • Reimbursement Collection

Call American Exchange today at 888.995.1674 or email us at  info@americanexchange.com