MPCA News

Update from the Partnership Health Center
by Lisa Reich

Partnership Community Health Center, Missoula

Partnership Health Center is in serious financial trouble. These were the headlines in Missoula one year ago. While the reality of the situation was not as dire as the media had us believe, it was true that Partnership Health Center, Missoula’s community health center since 1992, was in economic stress. Rapid growth and expansion over the last two years put the clinic in a precarious financial position as budgets, staff, and capacity swelled to meet the health care needs of Missoula’s medically underserved. The bottom line: expenses in fiscal year 2002 exceeded revenues by $560,000. The problem, according to Partnership Health Center’s new Executive Director, Ed Mahn, was not necessarily financial mismanagement, but one of strong dedication to the mission.

(L-R) Kim Mansch, CFO and Ed Mahn, CEO of Partnership Health Center

“In an effort to provide services to as many people as possible, the organization grew faster than the infrastructure to support it.” Ed says. Since coming on board in December, Mahn and Partnership’s new Finance Director, Kim Mansch, have worked with staff and community partners to institute changes in policies and procedures that are increasing efficiency within, to bring the organization back to a strong financial position. Extensive audits and systems analysis revealed a number of opportunities for Partnership to better recover the cost of providing medical and dental care to those who often cannot afford to pay.

These changes include requiring payment for prescriptions at the time of receipt of the medication; increasing minimum co-payment for dental services to $20.00; accepting credit and debit cards; billing Medicaid and Medicare electronically which resulted in a collection rate of 90% (up from 26% the previous year); extensive coding and collection training for billing and front desk staff, and capturing all hospital billing. The equivalent of 4.5 FTEs were lost as staff positions were eliminated, and others that were empty due to normal attrition were not filled. Daily collections increased from $300-$500 to $1,200-$1,500. Deficit spending was as high as $40,000 per month in the first quarter of FY03. The above-mentioned changes reduced this to $4,000 for December 2002, and revenues once again exceeded expenses by January 2003.

Partnership Health Center weathered these hard times due in large part to support from its Board of Directors, Missoula County Commissioners, the Health Department, local hospitals, and others in the community. The County agreed to underwrite the fund deficit for a period of ten years. Board members, Partnership Health Center staff, and the County were intensively involved in the search and hiring process for both the new Finance Director and Executive Director. “The community and the county really pitched in to help this organization.” says Mansch.

The problems Partnership Health Center faces are perhaps not unique to Missoula County. Across the nation, community health centers remain under-funded in the face of health care needs for the medically underserved. Partnership Health Center’s Healthcare for the Homeless Program is a telling example. As written into the operating grant, the program anticipated treating 450 patients, 1.7 times a year, for a total of 750 annual homeless patient encounters in fiscal year 2002. In actuality, over the past year Partnership Health Center staff saw 1,035 homeless patients for a total of 6,511 annual homeless patient encounters. At the fiscal years end, the Healthcare for the Homeless program was $140,000 over budget.

Mahn believes that the solution lies, not in denying health care to those in need, but in taking a business-like approach. “The future for Partnership Health Center and our patients looks brighter than ever before.” Mahn says. He points to strategic business plans now in place for the dental and medical clinic, and new operating systems that are increasing encounter rates throughout the clinic. “The pharmacy and dental clinic are planning to expand in the next year in a manner that both serves more residents in our community, and supports the long term sustainability of the clinic.”

In spite of the turmoil over the past year, Partnership Health Center has continued to deliver quality services to populations at-risk and in need through a partnership with Missoula County and numerous health care and social service organizations. Partnership expects to pay off the fund deficit well before it is due. “We have put many new systems in place.” Says Mahn, “The trick now is to keep a handle on what we are accomplishing today, while keeping an eye out for what we hope to accomplish ten years down the road.”

For more information about Partnership Health Center, contact Edward Mahn at (406) 258-4181; email: mahne@phc.missoula.mt.us

Montana Primary Care Association 1805 Euclid Avenue Helena, MT 59601 Phone: (406) 442-2750 Fax: (406) 449-2460