Health systems developing strategies to capture the newly insured

September 2013

For all of the attention the ACA puts on payment and delivery system reform, a potentially more important metric for providers is how well the law succeeds in reducing the number of uninsured. Hospitals and physician practice groups are banking on the idea that as more and more people gain some level of insurance coverage, the amount of unpaid care they provide will be greatly reduced.

That equation has already taken a hit, with state lawmakers now deciding whether or not to expand their Medicaid programs. But with enrollment in new insurance exchanges gaining speed, providers see some balance returning to the formula. Many of them have stepped up their roles in explain the law to their patients—and others are even more hands-on, helping the uninsured or underinsured actually attain coverage.

Here are 5 tips to consider:

  • Run the numbers. Review the amount of charity care provided and compare it to the potential new revenue from  patients  gaining some level of coverage.

  • Tap frontline staff to become counselors. Develop exchange training for financial counselors and hospital volunteers. Consider adding staff, too.

  • Wire into state exchange boards. Stay close to the decision-makers at the state and federal level. One medical center has staff that monitor all of the state’s insurance exchange activities, and some even sit on a state task force.

  • Target the right audience. Send out mailers that explain new coverage options to those patients who qualified for charity care in the past.  Visit health fairs, community events, and businesses to help people sign up on the spot.

  • Plug into local networks. Outreach efforts have a better chance of success if they are targeted, tailored and hyper-local. Identify a hospital employee who matches the profile of those eligible for subsidized coverage.