Advancing Primary Care

Grantee Name

CohnReznick LLP / J. H. Cohn, LLP

Funding Area

Advancing Primary Care

Publication Date

February 2015

Grant Amount

$147,250

Grant Date:

April 2013 – March 2014

Some FQHCs, however, already serve disproportionately large numbers of uninsured individuals and/or patients with commercial insurance, putting the viability of these health centers at risk.

In this new era of insurance expansion under the Affordable Care Act, FQHCs need to understand the law’s ramifications for their financial operations and position themselves for financial survival and growth. To help community health centers prepare for these changes and ensure their viability, NYSHealth awarded a grant to CohnReznick, an accounting and financial consulting firm, to provide technical assistance to five FQHCs with the largest proportions of uninsured and commercially insured patients in New York State.

Outcomes and Lessons Learned

  • Hired the law firm of Feldesman Tucker Leifer Fidell LLP to  review policies that would impact the future financial performance of the health centers and develop a report;
  • Began researching health reform initiatives in other states. As the project progressed, it became clear that the initiatives in New York were State-specific and that research into other states would not be as valuable as originally anticipated; 
  • Used nationally recognized and published studies/tools to project the impact health reform would have on insurance coverage and new patients accessing care; 
  • Developed a financial model that included patient volume projections by payer, a patient revenue impact analysis, and potential impact on staffing and other major expense items;
  • Completed and reviewed the financial modeling template with the FQHCs, which was adopted by all five;
  • Discovered a Medicaid billing rate error and filed a rate appeal, which was approved, on behalf of one of the FQHCs, Oak Orchard Health. As a result, Oak Orchard Health will receive an additional $750,000 per year in Medicaid reimbursements and has achieved financial stability; 
  • Held two to three site visits with four of the FQHCs to discuss health reform, steps to ensure preparation for success, and value proposition for the future; and
  • Determined the fifth FQHC, Hudson Headwaters Health Network (HHHN), was well-positioned for success and therefore, in place of technical assistance, provided guidance as HHHN expanded its market.