As more patients opt for high-deductible insurance plans, hospitals and health systems are using creative strategies to limit bad debt and keep patients happy, Dave Barkholz reports for Modern Healthcare.
Ascension Health CFO Rhonda Anderson says hundreds of the system's patients were drowning in debt from copayments and other out-of-pocket costs related to their high-deductible insurance plans.
Aggressively collecting payments was not ideal, Anderson explains, because it could damage patients' credit ratings. So the health system decided on a bold solution: Ascension would write off the deductibles of patients that earn below 250 percent of the federal poverty level. Rhonda says the move fit well with the 137-hospital Catholic health system's mission to help low-income patients.
Barkholz writes that many hospitals and health systems now have more flexibility to cover bad debt in certain cases because the drop in the uninsured rate under the Affordable Care Act has lowered the overall amount of bad debt hospitals face. For instance, Ascension saw its bad debt fall to 5.4 percent of revenue in 2015 from 6.3 percent in 2014.
However, the growth of high-deductible health plans could "undermine that progress," Barkholz writes.
As a result, some hospitals are finding ways to identify who exactly can and cannot pay—and maximizing efforts to collect payments ahead of time.
For instance, Gwinnett Medical Center in Georgia has hired several financial advocates who call patients with scheduled high-cost procedures—such as surgeries—between three days and 24 hours prior to their visit. The advocates estimate patients' out-of-pocket costs and use advanced software to evaluate credit scores and determine how much patients likely can afford to pay.
They also ask patients to pay their deductibles ahead of time over the phone.
For patients who don't pay ahead of time, the hospital sometimes sends financial counselors directly to hospital beds so patients can pay while they are still admitted, explains Cynamin Kinard, director of patient financial services at Gwinnett. The hospital also has partnered with a financing company that provides a 40 percent discount for paying at the point of service or an interest-free option with a 10 percent discount if a patient pays within one year (Barkholz, Modern Healthcare, 5/21).
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