SERVICES
PROVIDING A FULL-SCALE APPROACH
CDCI creates solutions for organizations that deliver measurable results.
Strategic Planning & Operations
CDCI works closely with the health center’s Senior Leadership Team and Board of Directors throughout all stages of the strategic planning process. CDCI’s principal, Curt Degenfelder, provides quantitative analysis and evaluates a health center’s current structure, operations and plans. He examines the metrics of payor mix, productivity, staffing, and key financial ratios. In writing the strategic plan, CDCI devises strategic solutions that encompass health center operations from appointment scheduling to patient discharge, health center regulatory & reporting requirements, Board & community relations, and cash considerations. The combination of analysis, environmental assessments, strategic plan creation, and monitoring are key elements to the successful implementation of a practical strategic plan that improves organizational issues, sets benchmarks, and provides positive bottom line results.
Financial Projections and Budgeting
CDCI works with health centers to create their annual budget for Board approval, as well as projections for new sites/services. Curt Degenfelder has developed budgets for more than 80 new sites and spinoffs, incorporating key elements of ramp-up and changes in staffing. CDCI budget creation includes elements such as changes in the external environment, evaluating provider productivity, and evaluating performance against defined metrics.
Training
Curt Degenfelder is one of the foremost trainers for health centers nationwide. He has performed trainings for the National Association of Community Health Centers (NACHC) for more than 20 years. He frequently provides trainings for state Primary Care Associations, both at annual conferences, as well as intensive all-day financial and operational sessions. Curt delivers trainings to health center leadership on operations and profitability, as well as to Boards on current issues.
Sliding Fee and Policy and Procedure Development
CDCI works with health centers to develop policies and procedures that 1.) Encourage efficient operating practices, 2.) Conform to HRSA regulations, and 3.) Reflect the health center’s actual operations and business practices. The policy and procedure review includes both a gap analysis of where the health center may be missing policies, as well as a review of existing policies. Where appropriate, CDCI will develop a service charge schedule in compliance with HRSA PIN 2014-02.
HRSA Site Visit Preparation
CDCI works closely with health centers to prepare for the HRSA on-site Operational Site Visit (OSV) that reviews grantee compliance with the 19 program requirements. Curt Degenfelder assists organizations in meeting the regulations for the fiscal, operational and administrative arenas of the health center. He supports the health centers by ensuring that their policies and procedures are HRSA compliant, including a gap analysis to identify missing policies, and educates staff members on what to expect during the site visit.
California Prospective Payment System (PPS) Rate Setting
CDCI assists FQHCs in obtaining PPS rates for new sites. Curt Degenfelder has assisted in the development of over 60 PPS rates in California. His extensive experience includes the development and application of criteria for three comparable clinic rate setting, utilizing a proprietary database of relevant data elements. He also assists in preparing the FQHC/RHC Medi-Cal Rate Setting Cost Report in conformance with the State Medi Cal cost reporting requirements. Curt has keen understanding of the ins and outs of rate setting, including determining which approach is most appropriate for the health center.
FQHC Grant Applications
CDCI has years of experience helping organizations complete New Access Point, Service Expansion, and renewal applications. He also assists organizations in securing FQHC and FQHC Look-Alike status; including new clinics, current clinics seeking FQHC status, and hospital/university spinoffs. CDCI’s comprehensive strategy includes assisting with the application to the Health Resources & Services Administration (HRSA), timeline sensitivities, financial analysis and education of the staff, Boards, and other key stakeholders about HRSA’s 19 program requirements. He helps health centers evaluate appropriate grant goals, including financial performance measures.
Development of FQHC Alternative Payment Methodologies (APM)
Curt Degenfelder is renowned nationwide as the leading expert in developing Alternative Payment Methodologies (APMs) for FQHCs. He developed the system in Oregon, regarded as the premier APM system nationally, and has also worked on FQHC payment reform efforts in California and Washington. He has assisted multiple health centers in developing APM rates and evaluated the financial and operational impacts of APM on the organizations. Curt has been tapped by National Association of Community Health Centers (NACHC) to partake in a workgroup to develop a resource for Primary Care Associations (PCAs) that are considering APM development. He is also helping implement PPS in the State of Wisconsin.
Change in Scope (CIS) Applications
FQHCs are reimbursed under the Prospective Payment System (PPS). PPS allows for a Change in Scope (CIS) whereby a health center can apply for a new Medicaid rate. CDCI has developed more than 100 initial and Change in Scope rates, utilizing cost reports, for health centers around the country, including California, Washington, Oregon, Connecticut, Wisconsin, Indiana, and Utah.
“One Community Health first engaged Curt Degenfelder Consulting (CDCI) to develop our APM rates. Our entire team found Curt to not only be a deeply knowledgeable subject matter expert, but he is also a great mentor and coach. Since that first engagement, we now routinely engage CDCI when we have business challenges or when exploring new opportunities. Most recently, CDCI has helped us on key projects including a Change in Scope and setting cost-based charges. On one project, Curt noticed issues in our reimbursement and was instrumental in helping us secure several hundred thousand dollars in back payments. We greatly appreciate the partnership we have with CDCI and see him as an extension of our team.”
“Community Health Partnership of Illinois used Curt Degenfelder consulting to help us complete our three-year strategic plan. Curt’s systematic approach allowed us to use the building blocks we had previously developed to create an effective plan that covers all of the key elements of our organization’s strategic transformation beyond our original migrant and seasonal agricultural worker focus to serve additional patients in our communities. Curt and Kerry had multiple interactions with our staff, refining all of the key elements. Curt also presented at our strategic retreat, to both our Board & leadership team, as well as to all staff, which was lively and well-received by all.”
“Progressive Community Health Centers used Curt Degenfelder Consulting in developing our three-year strategic plan. This effort was greatly complicated by the COVID pandemic. Curt did what he needed to do to understand our operations – visiting all of our sites, meeting with managers, providers, and staff focus groups, and talking to our community partners. He brought together a Strategic Planning Committee made up of key health center staff, with extensive Board member input. Despite multiple interruptions from COVID, Curt was able to help us complete an effective strategic plan in a timely manner. We now have a great tool to chart our future!”
“I was thrilled when my Board approved for me to retain Curt Degenfelder to perform a Medicaid rate analysis. Curt immediately jumped to the heart of the matter and identified two options for us that will place us in a much better financial situation. His proposal stated that he would get the work finalized within 5-weeks and he got everything finalized within 4-weeks, amazing! He did a thorough financial analysis and helped us select the best options for our organization. He also helped us implement the new rate and hooked us up with a peer health center that was able to answer some additional questions to help further speed up the process.”
“Montana loves Curt Degenfelder. He has been a featured speaker for the Montana Primary Care Association for many years. He takes complicated financial issues and models and shows us how to apply them right now. He listens to our members and is able to apply his trainings to the real circumstances in rural and frontier centers as well as our larger centers. Our members always look forward to hearing him speak. We wish he lived here!”
“We hired Curt Degenfelder to help us with a complicated Alternative Payment Methodology Change In Scope. He designed a thoughtful and systematic process towards completing the project. We were able to utilize multiple resources in our center to come up with a good result. Curt worked collaboratively with key stakeholders including the Primary Care Association and the Oregon Health Authority for a successful outcome. Curt has been a real asset to us, and to health centers in Oregon.”
Parktree Community Health Center has relied on the wonderful services offered by Curt Degenfelder in many phases of our development. Curt laid out a financial model that demonstrated the value of becoming a FQHC and assisted us in getting a great PPS rate. Since our inception, Curt has participated in our growth and expansion planning. He worked with us and our partner hospital, to envision both the takeover of a new site, as well as additional capacity to serve the long term needs of the community. Curt is respected by our staff, Board of Directors and is a pleasure to work with. His guidance is so valuable to us!
Curt Degenfelder has twice helped Apicha CHC develop and guide the implementation of our strategic plans and 330 funding applications. Throughout the planning processes, Curt was cognizant of our HIV and LGBT work which assisted in our ability to find the balance between that work and expansion of services in our service area. He sharply sorted out Apicha CHC’s complex business, providing information that were instrumental in our transition from a community-based organization to a community health center.
QueensCare Health Centers has been fortunate to have partnered with Curt to develop its last three strategic plans. Our most recent strategic planning efforts were interrupted by the pandemic. Curt quickly shifted from leading our strategic planning activities to trusted advisor. He helped our leadership team with emergent strategies to respond to the pandemic but also kept them thinking about and planning for the future.
We recently finished our strategic plan. In the meetings, some were reluctant to contribute to the dialogue but Curt has a way of drawing people out and in the end, I felt confident that we were able to align our team around a common vision, goals, and action plan.
His knowledge and experience in the healthcare industry have been a great contribution to QueenCare Health Centers.
