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Hospitals, staff & patients are facing a storm, whether they know it or not. There is more and more complexity in how they engage each other, but few tools to simplify and deal with the deluge of paperwork and confusion.. If you are involved in creating or improving the financial assistance experience at a hospital, below are challenges you may already know about - and also reasons for hope.
The Bad News:
1. A new standard restricts what hospitals may report as bad debt.
It used to be that - hospitals could calculate bad debt as the difference between the amount they billed their patients and the amount their patients ended up actually paying—even in instances when the hospital never expected to receive the entire amount billed.
But now - hospitals can only report bad debt when adverse events, such as bankruptcy or loss of employment, prevents a patient from paying what the hospital, based on historical experience, expected to receive. (more details here)
2 - Over a third of hospitals carry over $10 Million in bad debt.
Only 17% of bad debt is due to patient delinquency
The rest is due to ineffective facility-specific revenue cycle management, increasing complexities and regulations, and changes in reimbursement models.
3 - More Uninsured Patients = More Bad Debt
A 2018 study from TransUnion showed that patient balances after insurance (PBAI) grew by more than 52 percent between 2012 and 2017. And to make matters worse, 37 percent of Americans say they would go into debt if faced with a medical bill of $100 or more.
The Good News
1 - There is lots of room for improvement. Over half of all patient access functions remain highly manual. That means the opportunity to improve has not been squeezed out.
2 - Patient Financial Engagement and Self-Service Technologies offer hope.
When you streamline your screening and enrollment processes, hospitals see improvements in both reimbursement and patient coverage.
By simplifying the eligibility screening process by quickly populating multiple forms, capturing patient signatures, and submitting applications - all electronically - you provide a better patient experience and improve profitability. And today, tablet, desktop, or mobile devices are already available to most staff and patients.
3 - New approaches are being optimized and proven out
At a 400 bed community hospital patients enrolled within a 3-month period were tracked for use of healthcare over the next 12 months. Through enrollment into eligible programs, the hospital saw a decrease in unnecessary ER usage and a reduction in bad-debt from those patients.
At a multi-state revenue cycle company, self-pay patients were self-screened for program eligibility using an integrated text platform. The results were: a 10% increase in inbound engagement, and 90% increase in patients being cleared for assistance.
If you would like to extend your benefit screening and enrollment options into the community by offering a mobile solution, take the first step by scheduling a free Advocatia consultation & demo HERE
Advocatia Solutions (advocatia.io) provides hospitals with a platform to assist their uninsured and under-insured patient populations. Advocatia helps your patient financial counselors streamline "benefit triage" - the financial assistance process - and provides an optimized workflow to assist patients find coverage when they need it most.. Hospitals that partner with Advocatia increase reimbursements, decrease bad-debt and optimize their internal work-flows while creating an audit trail of enrollment. This win-win solution will have your patients AND your CFO sleeping better at night.