DEACONESS Hospital transforms uncompensated care into $670K in net revenue in less than 6 months.

Case Study: 300 Bed Community Hospital

Actual Financial Impact of Enrolling Chronic Lives January – March 2016

By using data you already own, MedAssist shines a light on key chronic patients within your uncompensated care population and launches a proactive recruitment campaign enrolling patients into the right plan.


The Challenge

During the 2016 HIE open enrollment period, about 12.7 million individuals either signed up for healthcare for the first time, or were automatically reenrolled into a 2016 Marketplace plan. In conjunction with open enrollment, the expansion of Medicaid in selected states and the extension of coverage for young people who can stay on their parents’ plans, 17.6 million people are now covered under the Affordable Care Act – the largest reduction in uninsured decades. However, healthcare systems and hospitals still faces open enrollment challenges in 2016:

 

Healthcare Costs

Hospitals continue to be challenged by bad debt because of uncompensated care and underpayments by Medicare and Medicaid.

 

Increase in Premiums

The average premium rate increase from states reporting data is 7.5% from 2015 to 2016 and patients will need financial management assistance.

Face-to-Face Engagement

50% in ACA-compliant plans say they got help with the enrollment process, and 90% of assisted programs have already been re-contacted with post-enrollment questions.

Time-Consuming Process

Helping consumers get
enrolled takes one to two hours per case.

 

 

Benefits

Hospitals can overcome challenges with knowledge from analytics:

  • Reduce uncompensated care costs
  • Improve quality of care
  • Increase collection efforts
  • Improve patient satisfaction
  • Bring about RCM efficiencies

 

 

 

 

The Solution

By using data you already own, MedAssist shines a light on key chronic patients within your uncompensated care population and launches a proactive recruitment campaign enrolling patients into the right plan. Our innovative solution, Access Analytics, identifies, secures and maintains enrollees.

Enrollment Analytics: MedAssist proprietary analytics track and identify uninsured patients driving uncompensated care costs. Our Eligibility Workflow system pro-actively identifies enrollees and determine their Medicaid or HIE eligibility, while analytics continuously monitor your uncompensated care patient population.

On-Site Staffing: MedAssist on-site Certified Application Counselors (CACs) or Navigators serve as face to face intermediaries between enrolled patient and HIE. CACs will engage with patients directly through scheduled revisits and call center operations, conduct onsite HIE education programs in addition to education through letters, email and other agreed upon means, as well as follow up via phone calls/electronically to secure completed applications.

Call Center: Our call center operations allows for us to engage with your target patient population directly, and invite them onsite for HIE education sessions. We ensure follow up with enrolled patients until 1st premium payment is made, and leverage the call center to conduct HIE education.


MedAssist Hypothesis on Targeted Outreach for Uncompensated Care

Certain population subsets drive uncompensated care costs. As exhibited by our case studies, the expenses tied to the uninsured, chronically ill population are main drivers of continued uncompensated care.

Our analytics platform is able to take data related to this population and provide key insights that were previously inaccessible about the behavior and costs of particular patients within the demographic.

The new information derived from analytics can be used to turn knowledge into action, such as enrolling these chronically ill, uninsured patients into insurance plans and managing the “population health” of the uninsured, ultimately driving uncompensated care costs down.


Our Analytics Approach

With the large amounts of data now being collected, providers can now identify trends to observe unknown relationships and make informed decisions. The key differentiator in analytics is taking the knowledge and driving actionable outcomes from that knowledge and insights gleaned.

  • Data: Data points are readily available throughout electronic systems.
  • Analytics Platform: An analytics platform will structure various data points and evaluate information.
  • Insight Analytics: Outputs help construct valuable insights via user-friendly viewing.
  • Action: Hospitals can overcome common challenges with knowledge from analytics.