Healthcare News & Insights

Why hospitals may see more uninsured patients & unpaid bills

Hospitals have been doing well under the expansion of Obamacare. But this prosperity may be coming to an end soon. In fact, if recent financial trends are any indication, facilities could be seeing a lot more unpaid medical bills from uninsured patients this year. 

ThinkstockPhotos-502057919According to an article in Forbes, the growth in the insurance market spurred by healthcare reform is finally starting to slow a bit. Instead, some hospitals are starting to see growth in an unwanted area: the number of uninsured patients who are seeking care.

One major hospital operator, HCA Holdings, saw a 6% jump in uninsured patients visiting the emergency department during its third quarter.

Reason for shift

Because patients in many states have access to healthcare coverage through the federal healthcare exchange, most hospitals have seen a decline in uninsured patients. However, according to a financial report from Fitch Ratings, more hospitals may end up in a position like HCA Holdings.

In particular, the report cites growing concerns about the “commercial viability of the public health insurance exchanges.”

Some payors have come out and said they’re evaluating their exchange plans to see if the model’s hurting their profitability. Insurance giant UnitedHealthcare recently announced that it’ll start taking a hard look at the exchange plans it offers – and it may pull out of the exchange altogether if they find the benefits aren’t worth the added costs.

Another situation that’s contributing to the rise of uninsured patients, per the Fitch report: “stalled progress of the expansion of state Medicaid programs.”

While 31 states (including Washington DC) have already expanded Medicaid through the healthcare exchanges, the others haven’t. And plans to extend coverage to more people in these states have fizzled, so they’ve had to rely on finding a private insurance plan through the exchange.

But if more private payors start thinking about limiting the options they offer, like UnitedHealthcare, these patients may find it much more difficult to obtain coverage down the line.

What hospitals can do

With these trends in mind, your hospital may want to start preparing now by reviewing charity care policies to see if there are any concessions you can make to get reimbursed as quickly as possible from patients who aren’t insured. You may want to expand your offerings for financial assistance, such as cash discounts or payment plans, to make it more likely that they’ll pay their bills.

You may also want to take a more proactive approach, like some hospitals have done in states where Medicaid hasn’t been expanded. These facilities are helping patients understand how they can obtain low-cost coverage on the healthcare exchange.

Example: Through the Insure Health. Insure Texas. program, the Texas Hospital Association has been emphasizing that exchange plans are available and affordable for patients from all income levels.

Whatever strategy your hospital decides to take, it’s key to start looking at exactly how treating fewer patients with insurance could hurt your bottom line, then come up with a way to mitigate some of the damage.

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