Sharp HealthCare Hits 32,000 Patients Mark in Helping Self-Payers Understand Government Options Using CoverageForAll.org’s Eligibility Quiz
Patient Advocacy System Improves Hospitals’ Relationships With Patients & Increases Revenue
SAN JOSE, CA — 07/11/12 — A task force effort between Sharp HealthCare and use of the Foundation for Health Coverage Education’s (FHCE) website, www.CoverageForAll.org has resulted in more than 32,000 self-pay patients helped through the maze of government health coverage programs, improving the hospital-patient relationship, while maintaining the patient’s dignity, according to Gerilynn Sevenikar, Vice President of Patient Financial Services at Sharp HealthCare.
“By administering a 5-question Eligibility Quiz to self-pay patients who present for treatment, we’ve changed our relationship with the patient by changing the conversation. Instead of ‘let’s talk about how you pay the bill,’ it’s now ‘let’s talk about what options are out there and find the right option for you,'” said Sevenikar. “The Quiz’s results allow our staff to have an informed discussion with the patient, making the patient part of the solution.”
Accessed through the hospital’s electronic medical record system, the Quiz’s unique URL generates a personalized list of public and private health coverage options for each patient. As part of a two-and-a-half-year pilot project with the FHCE, Sharp is able to communicate these options to the patient and assist with enrollment. Increasing their compliance with AB774, the patient’s printable list of options contains coverage program overviews and contact information, monthly costs, a sign-up checklist of important documents needed to enroll, and the applications for each program for which the patient is eligible.
“The fragmented system of publicly-sponsored health programs makes it difficult for people to sign-up for coverage and even more difficult to realize they are eligible,” said Philip Lebherz, Executive Director of FHCE. “Our Eligibility Quiz simplifies the complex system of state and federal programs by making it into a single online eligibility process.”
In 2009, Sevenikar and her team noticed a decline in self-pay patient collections (7%) coupled with an increase in self-pay account volume (9%) and an increase in self-pay dollars (17%). All of this coincided with a steep rise in unemployment in San Diego County from 5% to 12%. Looking for strategies to improve payments through better navigation of federal and state payment sources, Sharp chose to integrate CoverageForAll.org’s Eligibility Quiz into the Emergency Department registration process to educate any self-pay patients who were presenting for treatment.
“Most self-pay patients want to contribute towards their bill, but because of the laborious nature of qualifying for assistance on both the patient’s and the hospital’s end, they often had to give up and leave the hospital unfunded. The Eligibility Quiz helps to solve that problem,” said Sevenikar.
Sharp HealthCare’s four emergency rooms represent somewhat of an epicenter of the dilemma facing hospitals who serve indigent communities. A Patient Advocacy Analysis of the HIPAA-compliant data collected within Sharp’s Emergency Departments between March 2008 and April 2012 concluded that of the 32,180 uninsured patients presenting for care, 80.6 % were eligible, but not signed up for free or low-cost government-sponsored coverage, 16.6 % were eligible for private health coverage (individual, group, or COBRA) and 2.8 % were eligible for a high risk pool program, either California’s state program, MRMIP, or the federally-implemented Pre-Existing Condition Insurance Plan (PCIP).
“These findings are extremely troubling because it is very likely that Sharp will not be paid for the care given to these self-pay patients,” said Lebherz. “These hospitals are not unique; they’re typical of any institution with a 24-hour Emergency Department.”
The Foundation for Health Coverage Education (FHCE) is a 501(c) 3 non-profit organization with a mission to simplify public and private health insurance eligibility information in order to help more people access coverage. For more information, please visit www.CoverageForAll.org, friend us on Facebook, or follow us on Twitter (@CoverageForAll).