BluePath Health guides digital transformation for 18 Reasons, a nonprofit, community-focused cooking school, to scale its operation
18 Reasons is a 501c3 nonprofit cooking school on a mission to empower its community with the confidence and creativity needed to buy, cook, and eat good food every day.
In 2021, the organization launched its “Food As Medicine” program to even better serve individuals diagnosed with chronic health conditions affected by diet and lack of nutritional education. This program included grocery delivery, virtual services, and educational support.
Challenge
18 Reasons’ “Food As Medicine” program first grew through a partnership with health insurer Contra Costa Health Plan. This program eventually expanded into collaborations with Medi-Cal and other health insurance providers. However, this shift also introduced a new challenge: Operating as a health care provider, including billing for services, an entirely new discipline across the organizations.
The specific administrative and operational challenges encountered when integrating with health care billing systems included:
- Developing a health care billing capability and revenue cycle management processes.
- Ensuring program participants were eligible for reimbursement.
- Navigating the complex regulatory landscape of health care billing.
- Supporting sustainable program growth with limited operational infrastructure.
Solution
Health care billing is a complex process that can stretch organizations’ resources and capacity. 18 Reasons knew that it would benefit from connecting with a partner that understood the nuances of health care billing, specifically when supporting Medi-Cal members. To streamline the process of identifying a partner, 18 Reasons searched California’s PATH Technical Assistance (TA) Marketplace, which matched BluePath Health’s expert team focused on operations, technology, billing, and strategy. In addition to serving as a one-stop shop where entities can access curated and approved vendors, the TA Marketplace also provides funding for organizations like 18 Reasons to help them establish the infrastructure needed to implement Medi-Cal Enhanced Care Management (ECM) and Community Supports.
BluePath Health’s first area of focus was to work with 18 Reasons to deeply understand its operational and business approach and any existing gaps and opportunities to build a scalable operation under the CalAIM program. To achieve the nonprofit’s goals, BluePath Health and 18 Reasons would need to collectively build holistic health care billing capabilities through four main stages: analysis of the current state, defining operational requirements, selecting the vendor, and implementation to ultimately collect revenue in a predictable fashion and reduce denials.
BluePath Health initially supplemented 18 Reasons’ foundational research and existing systems and processes into health care billing and areas of need. This work included evaluating the organization’s manual, Google Sheets-based tracking system. BluePath Health also sought to understand how and which administrative tasks could be automated or streamlined with the support of a future digital transformation.
Through this comprehensive and collaborative approach, BluePath Health established a request for information (RFI) from potential billing partners. This strategic approach helped 18 Reasons narrow down a potentially bottomless pool of potential candidates while surfacing options that would be best suited to 18 Reasons’ unique needs by evaluating each vendor against the specific needs of the 18 Reasons team and future requirements.
Through subsequent steps to request proposals and experience demonstrations of the product, BluePath Health helped select and strike a partnership between 18 Reasons and a billing platform that was best suited to help 18 Reasons with its two biggest priorities: Claims processing and reconciliation.
BluePath Health supported the adoption, onboarding, training, and implementation of the structured workflows to maximize 18 Reasons’ investment in its technology partner for ongoing sustainability and scalability.
Outcomes
Through the partnership with BluePath Health, 18 Reasons benefited from a strategic, focused technology evaluation and adoption process. By evaluating both its technology and resource needs early in the process, BluePath Health was able to set 18 Reasons for success now and in the future. Now, the nonprofit has:
- An established, robust billing infrastructure.
- Automated systems to reduce errors and inefficiencies
- A path to sustainable program growth through the support of its technology investments that will not pull additional resources from its operations and business teams.
- Financial stability and growth opportunities earned through more Medi-Cal reimbursements, which supplement grant awards.
In 2025 and beyond, BluePath Health is poised to continue supporting 18 Reasons’ transformational growth through a Salesforce platform adoption, which will further automate and streamline their program delivery. BluePath Health is also supporting 18 Reasons’ growth goals, which include expanding partnerships with additional health plans and insurance providers, monitoring and refining workflows to adapt to evolving health care regulations and program needs, and building additional internal knowledge and capacity for the future growth and health of the organization.