Helena Indian Alliance's Leo Pocha Memorial Clinic is an urban Indian clinic funded under Title V of the Indian Health Care Improvement Act.
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The clinic has significantly expanded staff and services thanks to third-party revenue—especially from Medicaid.
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Just a few years ago, only 20% of patients who used the clinic had insurance. Today, up to 85% of patients have insurance.
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Helena Indian Alliance was able to remodel its reception area, purchase new equipment, and hire new staff because of increased third-party revenue.
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Helena Indian Alliance Executive Director Todd Wilson says this increase is due in large part to Medicaid expansion, which covers 91% of the Alliance's Medicaid population. More Medicaid-covered patients translated into an increase in third-party revenue from $150,000 in 2015 to $850,000 in 2018.
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"With third-party revenue, we were really able to expand our personnel and the services we provide." — Todd Wilson, Executive Director, Helena Indian Alliance
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This increase in revenue allowed the Alliance to hire nine new employees, including administrative staff, medical assistants, nurse practitioners, substance use disorder staff, caseworkers, and others.
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New patients without insurance are connected to an enrollment coordinator who explains the benefits of having insurance—for patients and the Helena Indian Alliance. The coordinators help them determine eligibility and enroll. Some patients initially resisted because they were used to relying solely on Indian Health Service (IHS) for health care, but Wilson says a little education convinces patients that insurance is also important.
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The Alliance's high insurance enrollment rate resulted in unexpected assistance earlier this year, Wilson says. "With the government shutdown, which temporarily cut off funding from IHS, we were able to sustain operations without any cutbacks because of third-party billing."
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