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H H S Department of Health and Human Services
U.S. Department of Health and Human Services
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HRSA's June Health IT Grantee Spotlight

“Improving Reimbursement Through Effective Use of a Cloud Based Practice Management System”

                                            RAHS logo.


This month the Health Resources and Service Administration’s (HRSA) Health Information Technology (IT) website highlights the University of Michigan’s Regional Alliance for Healthy Schools (RAHS)- a network of school based health centers located in Michigan. RAHS provides public health and clinical services to improve the well-being of over 2,000 students annually including their families and communities. To help provide these health care services, The Regional Alliance uses a cloud based practice management system, a web based software program accessed from a central computer server. This health IT solution allows The Regional Alliance a durable and cost efficient health IT solution to meet various reporting requirements, manage resources, and capture reimbursement.

School Based Health Centers and the U-M RAHS Program

School Based Health Centers serve as “the center of health in the schools where they are based.” Specifically, they are a health center located within a school that provides clinical and public health services to students. Many students rely on these programs for access to a full range of health services including:

        • primary medical care
        • mental/behavioral health care
        • dental/oral health care
        • health education and promotion
        • substance abuse counseling

School Based Health Centers are often operated as a partnership between a school and a community health organization, such as a community health center, hospital, or local health department. The specific services provided vary based on the community’s needs and available resources and are established through collaborations between the community, the school district and the health care providers.

Nearly 2,000 school based health centers operate nationwide, according to the most recent National Assembly on School-Based Health Care census. Furthermore, School Based Health Centers received increased support through the Affordable Care Act and HRSA’s Bureau of Primary Healthcare

Room in the University of Michigan.
Washtenaw County school building.







Founded in 1996, the University of Michigan (U-M) Health System funds (along with the Michigan Departments of Community Health and Education, and various other local sources) and operates the RAHS Health Center Program which consists of six school-based health centers in four school districts within Washtenaw County.

The Value of  a Practice Management System

In 2003, the State of Michigan cut funding to School Based Health Centers and increased reporting criteria for patient services. In response to these challenges, the Regional Alliance worked with School-Community Health Alliance of Michigan (SCHA-MI) to identify a stable, affordable electronic system that would allow them to track and document patient encounters while also supporting their new reporting requirements.  

A patient management system allows a healthcare system to manage the business aspects while also supporting data reporting needs. Most patient management systems support scheduling, billing, coding, track reimbursements, resources and cost utilization, and support workflow analysis.

SCHA-MI, the organization that represents and supports Michigan’s School Based Health Centers, evaluated multiple products before selecting an cloud based solution. By selecting an cloud based program management system, the Regional Alliance avoided the costs associated with having to purchase expensive hardware such as servers, needing to purchase software, or hire staff specialized in supporting the software. The cloud based system allows users to access the PMS software directly through the internet. The resulting advantages included:

Decreased Costs: SCHA-MI was able to purchase a large number licenses for all school based health clinics throughout the state.  This allowed SCHA-MI to negotiate a better price per license.  The large group purchase also reduced the overall cost of staff training.

Enhanced Infrastructure: SCHA-MI ,in partnership with the Michigan Primary Care Association (PCA), maintains the PMS servers and data. Since Michigan PCA is a HRSA funded Health Center Controlled Network, they have the health IT and safety net provider expertise to host the servers used by Michigan’s SBHC, therefore reducing cost and increasing efficiency.

Although, this PMS system contains an electronic health record (EHR), The Regional Alliance must use U-M Health Systems EHR, while maintaining their own PMS system for billing and business services.  The cloud based PMS system allowed The Regional Alliance to meet their business system needs, while still using the U-M Health System’s EHR system.

Augmented Data Reporting: The PMS Software has the ability to report the data required by the State of Michigan. In addition, the system’s data reporting capabilities are customizable to meet the various cost and reporting data requirements required by funding entities. The Regional Alliance, as well as school based health centers funded by the State of Michigan are required  to submit regular quarterly reporting. These reports includes include demographic data counts, service breakdowns, types of services billed for Medicaid plans, as well as other specific data requests.

New Cloud Based Practice Management System Brings Positive Results

Since, implementing a cloud based PMS system, The Regional Alliance has experienced many positive results, including an increase in captured reimbursement. As demonstrated by the chart below, since implementation of the new project management system,  the percent of paid claims has increased dramatically. This increased ability to capture reimbursement has allowed the Regional Alliance to expand their mission by opening new clinics while also expanding services.        

The cloud based PMS also allows The Regional Alliance to capture data on all provided clinical services. This is important since not all provided services are reimbursable. Examples of services that may not be reimbursable include: patient education, mid level provider services, mental health, and counseling.  Capturing service utilization allows The Regional Alliance to better understand  which services are more utilized. Additional this service data can be used for grant writing, mission alignment, community outreach, or additional reporting requests.

For more information
Please email Dr. Jennifer Salerno, Director, Regional Alliance for Healthy Schools at or Brenda McLean, the Practice and Data Network Manager of the School-Community Health Alliance of Michigan at