How healthcare providers can help the 5.4 million people that have lost insurance

• The coronavirus pandemic stripped an estimated 5.4 million Americans of their health insurance between February and May due to job loss, according to a Families USA study reported by The New York Times.
• According to the study 46% of the coverage losses from the pandemic came in five states: California, Texas, Florida, New York and North Carolina, according to the Times.
• In the 37 states that expanded Medicaid under the Affordable Care Act, 23% of laid off workers became uninsured, and in the 13 states that did not expand Medicaid, 43% of laid off workers became uninsured, according to the study as reported in the Times.

An article in The New York Times covering a recent Families USA study reports: “The coronavirus pandemic stripped an estimated 5.4 million Americans of their health insurance between February and May, a stretch in which more adults became uninsured because of job losses than have ever lost coverage in a single year, according to a new analysis. 46 percent of the coverage losses from the pandemic came in five states: California, Texas, Florida, New York, and North Carolina. In Texas alone, the number of uninsured jumped from about 4.2 million to nearly 4.9 million, the research found, leaving three out of every 10 Texans uninsured. In the 37 states that expanded Medicaid under the Affordable Care Act, 23 percent of laid off workers became uninsured. The percentage was nearly double that — 43 percent — in the 13 states that did not expand Medicaid, which include Texas, Florida and North Carolina.”

Takeaway

HFMA, with the support of State Collections Service, is working with a taskforce of revenue cycle leaders and consumer advocates to update its medical accounts receivable resolution best practices via its Healthcare Dollars & Sense initiative. While the prior version included a discussion of the important role patient education and engagement plays in resolving accounts, the revised draft will emphasize education and engagement much more strongly. The revised best practices are expected to be available at the end of the summer.

It will also reiterate that education and engagement is not a one-time activity to be completed prior to service (for non-emergent patients) or post-discharge (for emergent patients) but something that should occur through every interaction with the patient.

Since the initial version of the best practices was released six years ago, experience has shown that health systems that do a better job of educating patients about what to expect through each stage of the revenue cycle process are more likely to have patients who are engaged in the process. These educated patients also become active participants working with the provider to resolve their accounts. 

Topics providers should discuss with patients

At all times, core goals of the patient engagement and education should include a discussion of:

• Revenue cycle process, including the steps from pre-registration to appeals, estimated timing and who to contact with questions about the patient’s account.
• The provider’s account resolution policies.
• The potential for surprise bills and how to avoid them.
• Information necessary from the patient and referring provider, if applicable, to file a clean claim for insured patients.
• Sources of potential coverage and enrollment process for uninsured patients.
• Provider’s financial assistance policy and how to apply.
• Obtaining an out-of-pocket estimate of the patient’s responsibility.
• Options for payment plans and the process for establishing  one.
• Obtaining consent from the patient to contact them and identify their preferred communications mechanisms.
• How to select and update communications preferences, including contact information.

Beyond being the right thing to do from a business perspective because these best practices can help providers increase yields on cash balances and reduce the risk of negative media coverage, it’s the right way to treat patients. It’s what we all want our providers to do when our time comes to stand on the other side of the registration desk.