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Writer's pictureRajib Ghosh

Cost-Effective Management of Revenue Cycle with Data and Analytics

A New Frontier in the 1115 Medicaid Waiver-Driven Social Care Landscape



Published July 30, 2024 in Healthcare Analytics


I recently attended a conference in sunny San Diego, Calif., where leaders from different states, counties and community-based nonprofit organizations discussed the best ways to handle cross-sector coordination of care for the most vulnerable communities in the U.S. It was certainly an eye-opening conference. Opportunities to bring together healthcare and social care were discussed, as well as the development of more analytical solutions to adequately bridge the two.


However, there are several challenges. Managing the revenue cycle within smaller community-based organizations is a critical hurdle that several organizations are still learning. The excellent news is that owing to a growing nationwide awareness, health-related social needs are no longer the pariah in healthcare that seldom gets funded. For decades, policymakers, practitioners and social workers have recognized that to improve the health outcome of the most vulnerable communities in the country, health-related social needs should be handled as the fundamental building blocks. There was no shortage of recognition and acknowledgment of this, but not much sustained funding was associated with the two major government programs: Medicare and Medicaid. Several social determinants of health (SDOH)-related bills, on some occasions bipartisan, died on the Congress floor. Political analysts can look for the root causes of such failures. Still, the bottom line remained for the organizations providing health-related social needs services; they must rely only on philanthropic funding.


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