Clinic strategies increase revenue, create savings

The Tribe's Health and Wellness Center has been working on a number of strategies to promote healthy individuals, families and community.

The strategies are in response to the Tribe's 2010 Strategic Plan that focuses on government improvement by implementing measurable goals.

In the last six years, the clinic has doubled annual revenue to almost $10 million. One strategy for continuing to increase clinic revenues is going after new or increased reimbursements from Medicaid, Medicare and private insurance.

Added to these is a Tribal agreement with the U.S. Department of Veterans Affairs. Previously, veterans were required to obtain medical care at Veterans Affairs hospitals and clinics. The federal government now reimburses the Health and Wellness Center for services Native veterans receive at the clinic. The reimbursement for services helps increase Health and Wellness billing revenues. 

With almost 200 veterans identified so far, this creates a significant new stream of revenue for the clinic, says Tresa Mercier, Health and Wellness Business Office manager.

A second strategy to increase revenue is adding new services. Last year, the clinic added physical therapy and massage services. This year, the Tribe will employ Elizabeth Bush as the new mental health provider for depression screenings and follow-ups. Added to alcohol and drug services will be eligibility for the families of patients.

"We opened Behavioral Health services to the whole family," says Julie Davis, Clinical Services director, "so we can serve parents who might need counseling. We added family (as eligible for these services) with the goal of making the whole family well."

Later this year, a women's transitional center for eight women and their children will open.

Also adding to the clinic's income is the addition of the Pharmacy's mail order service.

The other side of increased revenue is increased savings. Part of that strategy is to offer assistance to Tribal members and the community in applying for Cover Oregon marketplace products made available by the Affordable Care Act.

"We feel that assisting our patients and Tribal members apply for these health coverage products will not only increase revenue for the Health and Wellness Center, but also decrease costs for the Skookum Health Assistance Program," says Mercier.

Loretta Meneley, Certified Application Assister, is located in the Health and Wellness Center and able to assist Tribal members, families and community members in applying for health care coverage through Cover Oregon. She can be reached at 503-879-1359 or 800-775-0095 for information and assistance.

Mercier credits her staff - Melody Baker, Barbara Steere, Tauni McCammon, Erica Mercier, Amber Yates, Meneley, Kayla Leno and Desiree Allen - for bringing these new sources of revenue to fruition.

"They work directly with the membership and patients at the clinic in applying for Cover Oregon," Mercier says.

Savings across the board will come from preventive activities, including individualized education, identifying at-risk individuals and using resources and outreach to improve outcomes, and further development of fitness programs.

Mercier says it is also important to maintain the clinic's accreditation from the American Association of Ambulatory Health Care.

The Health and Wellness Center's annual budget has always been covered by grants from a variety of sources, including Indian Health Service, Medicaid and Spirit Mountain Casino dividend dedicated to the program.

For questions about insurance coverage that you might be entitled to, or any others concerning clinic programs, contact Tresa Mercier at 503-879-2008, Julie Davis at 503-879-2299 or General Manager Mark Johnston at 503-879-4638.