Act Now to Protect Your Health Center’s Cash Flow — and Your Patients

Act Now to Protect Your Health Center’s Cash Flow — and Your Patients

As federal budget negotiations drag on, FQHC leaders once again find themselves planning for continuity in the face of uncertainty. The headline: even during a shutdown, patient care continues—but operations can still feel the strain, especially in billing and cash flow.

What the Latest Guidance Says

Section 330 drawdowns continue: HRSA/BPHC has confirmed that funded health centers can keep drawing obligated Section 330 grants through the Payment Management System (PMS) during a shutdown. If your drawdown requests stall, escalate immediately through your HRSA Project Officer and Grants Management Specialist.

Medicare and Medicaid payments continue: These are mandatory programs, and Medicare began releasing payments again on November 1 after temporary delays caused by administrative constraints. However, some processing and oversight functions may still move slower than normal.

Federal workforce furloughs remain a factor: HHS’s contingency plan calls for furloughing roughly 40% of staff during a shutdown, which can disrupt public health communications, grant processing, and other support functions health centers rely on indirectly.

The Stakes for Patients and Communities

Health centers now serve more than 52 million patients across the United States—a record high. Any disruption to cash flow cascades across millions of low-income, rural, and medically underserved patients who depend on continuity of care.

In 2023, Medicaid represented about 43% of total health center revenue, and Section 330 grants accounted for roughly 11%. With national operating margins averaging just 1.6%, even modest delays or denials can quickly tighten operations.

Immediate Actions to Stabilize Operations

1. Guard and grow your cash on hand.
Best practice for health center liquidity is now a minimum of 90 days cash on hand. Anything below that puts operations at risk if funding slows or reimbursements are delayed. If you’re under that threshold, activate a preservation plan immediately: slow discretionary spending, accelerate collections, and pause nonessential capital projects.

2. Accelerate accounts receivable—without triggering denials.
Industry denial rates have climbed to nearly 30%, almost triple historic averages. That means nearly one in three claims is delayed, denied, or reworked. Strengthen your front and mid-cycle processes now to protect cash flow:

• Verify eligibility and coverage before every visit.
• Resolve coordination of benefits (COB) issues proactively.
• Ensure complete documentation and charge capture before submission.
• Target follow-up on claims aged 60–120 days, focusing on partial payments and pended claims.
• Automate repetitive tasks to free staff for high-value recovery work.

3. Forecast and scenario-plan grant timing.
Even if 330 drawdowns continue, anticipate slower activity for other federal programs and approvals. Build a 90-day liquidity runway that covers payroll and core expenses without assuming federal inflows.

4. Stay proactive on telehealth billing changes.
Medicare’s temporary telehealth flexibilities expired on September 30, 2025, pending Congressional renewal. CMS has issued interim guidance and is holding certain claims to verify compliance. Review codes, modifiers, and provider locations closely to avoid rejections or takebacks.

What We Can Do Together

It has never been more important to maximize patient service revenue and ensure that every billed claim becomes a paid claim. Opportunities often hide within your existing accounts receivable—dollars already earned but not yet collected.

At Synergy Billing, we’re here to help uncover them. Our team offers a Complimentary Analysis to value your accounts receivable and forecast your patient service revenue for the year ahead. With just a little data and time, our experts can help you see where cash is locked up and how to bring it forward—no obligation, just valuable insights to help you lead with clarity and confidence.