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A Two-Pronged Approach to Tackle Your Uncompensated Care Costs

by | Mar 17, 2022 | coding, Data, Medical Billing, Revenue Cycle Management

The amount of medical debt turned over to collections makes up the largest amount of consumer debt in the US. This is particularly concerning for providers who are facing slimmer margins as a result of increased costs and decreased patient volumes.  

As of June 2020, researchers estimated that 17.8% of individuals in the US had medical debt that had been turned over to collections (JAMA). The study is based on consumer credit reports from January 2009 to June 2020, so it reflects medical debt prior to the onset of the pandemic. 

An individual’s total amount of unpaid debt (referred to as the mean stock and flow on the charts below) was $2,396 in 2020. 

Medical Debt Hits the Southern US and Low-Income Individuals the Hardest

As the charts show, overall, medical debt has declined since 2013. Researchers cited that medical debt decreased more in states that expanded Medicaid in 2014 than those that waited a year or haven’t expanded at all. 

People living in the Southern US faced the highest amount of medical debt:

  • 23.8% of individuals in the South held medical debt
  • Their mean amount of medical debt was $616 

Nationwide, people living in lowest-income areas based on zip code data had the highest amount of medical debt: $677.

Millions of People in the US are Still Uninsured

According to the CDC, more than 31 million people were without health insurance in the first six months of 2021. While the 2022 Affordable Care Act open enrollment period drew a record 14.5 enrollees, CMS reported that only 3 million were new enrollees. So, there are still millions of uninsured patients who could seek care from your facility. They could have more severe health issues if they haven’t sought care during the pandemic. 

Tackling Uncompensated Care at the Front and Back End of the Revenue Cycle

You need to address the problem of uncompensated care from both ends of the revenue cycle if you are going to impact your uncompensated care costs.

Getting uninsured or under-insured individuals enrolled into health insurance

Despite more affordable healthcare options, increased program promotions, and an extended open enrollment period, millions of people did not sign up for coverage. So, when a patient presents, it is critical to assess their eligibility and get them enrolled right then and there. It might be the only chance you have to get the patient covered so they can improve their overall health and you can get reimbursed for services rendered. 

Performing the eligibility assessment and asking the patient to reach out to an enrollment specialist after they leave your facility is not a sound approach. You’ve tried it and it hasn’t worked. If you don’t have the staff or expertise to handle both functions, find a vendor that can assess and enroll uninsured and underinsured patients.

Identifying Coverage for Services Already Rendered

Did you know that about 5% of medical debt written off by providers can be recovered? Insurance discovery is a solution that identifies coverage at the time of service for care you have already provided. People may have forgotten about a secondary policy. Or they may have  retained employer insurance for a few months after leaving their jobs, but they forgot since they were no longer working there. Regardless of the reason, insurance discovery solutions can reduce your uncompensated care costs.

American Exchange Can Help You at Both Ends of Your Revenue Cycle

American Exchange has a team of experienced public and private health insurance benefits managers that can assess and enroll eligible patients in affordable health plans. This includes ACA plans, Medicare, Medicaid, and Children’s Health Insurance Programs (CHIP). We’ve enrolled more than 60,000 individuals and families in ACA plans. We’ve also enrolled more than 17,500 in plans through the Ryan White program. 

Let us reduce your medical debt and create a steady cash flow with our enrollment and uncompensated care solutions. Contact us today.

Call American Exchange today at 888.995.1674 or email us at  rcm@americanexchange.com