Sharp shows how to serve the uninsured

March 4, 2013 in Medical Technology

Health facilities incur more than $39 billion annually in uncompensated costs due to care administered to the uninsured.

In an education session Monday titled “How Hospitals Improve Their Bottom Line and Improve Relationships with Uninsureds,” two people on the front lines showcased an innovative, IT-enabled approach to “transition from seeing these patients as a burden,” and toward a way to better engage them in financing their care.

San Diego’s Sharp HealthCare, upon realizing that 80 percent of uninsured patients presenting at their EDs qualified for government programs, developed a point-of-care enrollment assistance program that led to millions of dollars in new reimbursements.

In the session, Gerilynn Sevenikar, Sharp’s vice president of patient financial services, and Ankeny Minoux, president of the Foundation for Health Coverage Education, showed how it worked.

Minoux pointed to her foundation’s mission to “strengthen the dignity of self-pay patients” and emphasized the value of “training staff to become resources for the uninsured.”

With the Affordable Care Act paving the way for many new coverage options to exist by 2014, “developing a patient coverage education process now will prepare your health system to more effectively deliver coverage options and care to the uninsured,” she noted.

There are currently 48.6 million uninsured people in the U.S. But whether they’re folks with preexisting conditions, low-income adults, “young and invincibles,” veterans or the recently unemployed, there are many different and often under-publicized options available to get them coverage.

At Sharp, Sevenikar noticed – in lockstep with the 2008 recession – a decline in self-pay patient collections with an increase in self-pay account volume, leading to a $3.4 million loss for Sharp.

Its revenue cycle division had “always focused on leveraging IT to improve process,” she said. Now, they realized something else was needed: a process of “engaging with patients so they would see us as an advocate in their financial care.”

Most uninsured wanted to pay, she said. But they “just wanted longer to pay, or they wanted to pay less, or they just didn’t know what their options were.”

Minoux explained how Sharp put in place a tool that “presents patients with solutions,” guiding them to help them in “choosing coverage that’s best for them.”

The technology screens patients in just 90 seconds, then scans the entire U.S. healthcare coverage system for a personalized list of coverage options. Most patients, in just a couple minutes, go from seeming like they have no options to having a list of them.

“Seeing your healthcare provider walk you though those options, and be your advocate, is a big shift,” said Minoux.

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