Small Percentage of Uninsured Patients Generate Most of Hospitals’ Self-Pay Payments

Approximately one-third of patients—those without health insurance or those who have a patient balance after insurance—account for more than 80 percent of the self-pay revenue collected by hospitals. according to a TransUnion Healthcare analysis.

The findings are significant because the number of patients without health insurance increased to more than 12 percent in 2017 from 10.9 percent in 2016. In addition, patient balances after insurance (PBAI) have been steadily rising, increasing from 8 percent of the total bill responsibility in Q1 2012 to 12.2 percent in Q1 2017.

Optimizing revenue cycle operations can ensure that earned revenue becomes paid revenue, according to TransUnion Healthcare experts. For example, revenue cycle leaders should monitor the following areas:

• Focus on accounts that are most likely to be paid in full.
• Identify billable insurance as between 1-5 percent of self-pay accounts that are written off as bad debt actually have billable-insurance coverage.

“Re-evaluating a hospital’s current approach can be a challenge for revenue cycle leaders, but it can result in a great reward by maximizing the healthcare providers’ overall return,” said Dave Wojczynski, president of TransUnion Healthcare. “Determining which patients or accounts may present the best opportunities for payment is just one way a healthcare provider can increase its chances of maximizing reimbursement for services rendered.”

Self-Pay Account Patient Responsibility