Long Island Select Healthcare (LISH), a Federally Qualified Health Center (FQHC) in Suffolk County, offers more than 15 home and medical services, ranging from dental and gynecology to psychiatry and mental health care. After combining three Long Island Human Services agencies, LISH launched in 2016 and is now dedicated to providing access to quality and comprehensive healthcare respecting the unique abilities and needs of patients throughout their lifespan. In 2022, LISH officially partnered with Yuvo Health with the intention of growing their organization even further.
Challenges as an FQHC
While many other FQHCs have been around for decades, LISH is still a relatively young organization and its biggest challenge is figuring out how to do more with less. For FQHCs, costs of supplies and expenses have increased, but rates haven’t changed. “I would love to give more bonuses and raises,” says James Powell, MD, Chief Executive Officer at LISH. Right now, it’s hard to attract and retain providers. At times, the organization has to run short-staffed, which limits the availability for patients. It’s a delicate balance to grow the organization without burning out the existing workforce, Dr. Powell explains.
Finances are also very limited and the value-based model doesn’t guarantee reimbursement, which puts a lot of the risk on LISH and other FQHCs. In value-based propositions, the focus is put on outcomes, Dr. Powell says, which means FQHCs don’t get paid until the value is proven, and that reimbursement may not arrive for months after the services have been provided. LISH invests its own money into staff and services that they know will improve the overall health of a patient. They retain a wellness advocate on staff and provide wellness services, such as assisting patients with medical bills and connecting them to transportation, but these aren’t billable services in the existing value-based model.
Closing the loop on referrals has also been difficult for LISH. Patients are often referred to other organizations, but LISH has no way of confirming receipt of service. Building a system and process for data sharing would help to better monitor the patients’ health. Even within its own organization, LISH experiences 20-40% no-show rates, depending on the specialty. Often patients move, change insurances, have limited or no access to transportation, or simply can’t be tracked down – and LISH would like to resolve this issue.
Finding Solutions in Partnership with Yuvo Health
“It’s always attractive to talk to like-minded team members who understand the problems we face everyday. They may not have the solutions, but they have the desire and willingness to help us find the solutions,” says Dr. Powell.
“We’re a young organization, Yuvo is young. Yuvo is eager; we’re eager. We’re very aligned in that way and this gives us the potential to really share our vision of where things will go. We can help shape each other.”
Dr. Powell sees the new partnership with Yuvo as a great learning opportunity. Yuvo works with FQHC partners to unlock new revenue streams through value-based care so they can better address the unique needs of diverse patients.
“We’re so used to viewing healthcare and the delivery of healthcare in the lens we’re comfortable with, but to have additional people on the Yuvo team saying, ‘have you considered this? ‘What about this?’ It’s exciting. If you’re not a lifetime learner and willing to be vulnerable, you’re never going to grow,” says Dr. Powell. “It’s nice to have that offering.”
Partnering with Yuvo, Dr. Powell wants to gain more access to patients who don’t regularly visit the health center. At one time, they developed a program to bring in patients who are already in the system but haven’t returned, but could only get 20%. “We could definitely use assistance in helping grow those relationships with patients,” says Dr. Powell.
“If we could move the quality metric needle of our patients, that would be phenomenal, and if there’s an opportunity to obtain profit that could then be applied to staff who are doing the work, then that would be even better. You have to find the balance in purpose and profit in an organization like ours,” says Dr. Powell. “If I can have someone help us do both so I can retain my employees and move the needle for better outcomes for our patients, then that is a win-win.”
Working with Yuvo, Dr. Powell feels hopeful this will become a reality.
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