Hos­pi­tals step up en­roll­ment ef­forts

Modern Healthcare - - NEWS - By Beth Kutscher

Many health­care providers are see­ing fi­nan­cial benefits from Oba­macare in­surance ex­pan­sion across the coun­try, while those that haven’t are re­dou­bling their ef­forts to sign up the most chal­leng­ing of their unin­sured pa­tients, said pan­elists at the Health­care Fi­nan­cial Man­age­ment As­so­ci­a­tion’s 2014 An­nual Na­tional In­sti­tute.

The Level 1 trauma cen­ter at Cooper Univer­sity Hos­pi­tal in Cam­den, N.J., a city with a 40% poverty rate, of­ten re­ceives the vic­tims of vi­o­lent crime. “The big­gest chal­lenge was to con­vince peo­ple we were do­ing some­thing good for them” by en­cour­ag­ing them to get in­surance, said John Bucci, Cooper’s direc­tor of pa­tient ac­counts. “There are a lot of peo­ple who walk in and they’re not ready to co­op­er­ate.”

Cooper set up kiosks through­out the hos­pi­tal and of­fered a toll-free num­ber for in­di­vid­u­als to get more in­forma- tion about sign­ing up for a pri­vate health plan. But many peo­ple balked when they re­al­ized they would have to pay pre­mi­ums. “We didn’t re­ally have a huge re­ac­tion to it,” Bucci said. Some pa­tients who did sign up would pay a month or two of pre­mi­ums and then stop.

The big­gest boost for the hos­pi­tal is New Jersey’s pre­sump­tive el­i­gi­bil­ity for its ex­panded Med­i­caid pro­gram, which al­lows pa­tients to au­to­mat­i­cally qual­ify based on in­come. Al­ready the num­ber of self­pay pa­tients has dropped 40% and charity care has de­creased by a third.

The Univer­sity of Florida Health Jacksonville hasn’t seen the ex­pected en­roll­ment re­sponse in pri­vate ex­change plans and in­tends to con­tinue its out­reach, said Ja­son Hard­wick, direc­tor of pa­tient ac­cess and fi­nan­cial el­i­gi­bil­ity. Florida didn’t ex­pand Med­i­caid to low- in­come adults. Next year, UF Health plans to part­ner with an in­de­pen­dent foun­da­tion that will of­fer pre­mium as­sis­tance to el­i­gi­ble in­di­vid­u­als.

Cooper al­ready is us­ing that ap­proach. “We’ve pro­vided a lot of pre­mium as­sis­tance,” Bucci said.

Life Point Hos­pi­tals, a pub­licly traded, Brent­wood, Tenn.-based chain, re­ported in its first-quar­ter re­sults that 22% of its self-pay pa­tients had en­rolled in Med­i­caid and 3% had en­rolled in an ex­change plan in the 20 states where it op­er­ates. Those num­bers were above its ex­pec­ta­tions. More­over, it said con­cerns about bad debt from high­d­e­ductible ex­change plans have been un­war­ranted.

“Our av­er­age pa­tient re­spon­si­bil­ity is $176,” said John Kerndl, Life Point’s chief fi­nan­cial of­fi­cer of op­er­a­tions. “It’s been a pleas­ant sur­prise.”

“There are a lot of peo­ple who walk in and they’re not ready to co­op­er­ate.”

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