CVHS Case Study

Challenge

Balancing Quality and Efficiency

For Community Health Centers, balancing quality patient care with operational efficiency is no easy feat.

CVHS faced stagnant Medicaid rates, increasing costs, and a critical period of Medicaid unwinding.

Mounting pressures threatened their ability to maintain operational capacity and deliver care at the level patients needed. Without the ability to grow their staff, CVHS sought an innovative solution.

Core Obstacles

Current employees were stretched thin, juggling enrollment tasks alongside their primary responsibilities.

Static reimbursement rates since 2001 despite rising costs.

Limited IT resources inhibited capacity to research, implement, or manage solutions effectively.

Solution

Intelligent Enrollment Automation

CVHS implemented Pointcare's coverage management platform to automate the tracking and renewal of Medicaid enrollments.

By minimizing the need for time-intensive manual intervention, staff could reallocate their energy to more critical tasks.

Strategic Alignment

Enrollment tracking that identifies lapses within the billing window.

Performance-based approach with regular reviews to ensure success.

Self-service features for patients comfortable managing coverage at home.

Outcome

Efficiency Meets Empathy

Innovative technologies can drive meaningful change, even when facing financial and operational headwinds.

Proactive Coverage Management

CVHS maintained patient coverage levels during the critical unwinding period while slashing administrative costs by nearly 65%.

By automating manual workflows, staff were freed to focus on high-value community outreach and education, safeguarding critical revenue streams and ensuring continuity of care when it mattered most.

Support the Staff:

Scale Enrollment Capacity Without Adding Headcount.

$287,300+