Uh oh… Uninsured Americans Up 3M in 2019

The healthcare industry is abuzz with the latest update from the Congressional Budget Office (CBO) that, with the repeal of the individual mandate, premiums will increase approximately 15% next year and the number of uninsured Americans will rise by an additional 3M lives.

However, CBO is a “forecasting” entity and it remains to be seen what 2019 will actually look like, but healthcare providers need to prepare. That is why a forecast is important. Preparation is key to managing any potential crisis that may occur at a later date.

Recently I have noticed a dramatic increase in the rise of out-of-pocket (OOP) amounts owed by the patients we treat. While insured, there is a cost-shifting occurring from payers to patients on what they will allow of a provider charge, if non-contracted, or an increase in co-pays and deductibles.

More than ever before, it is vitally important that providers and suppliers of healthcare have a strategy on how to attack this issue. Here are a few ways to begin the management process regarding rising OOP:

1. Deductible management.

2. Understand the payer behaviors of the age groups of the patients you treat.

We identify age groups as follows:

  • newborn to 18 years old
  • 19 – 30
  • 31-40
  • 41-50
  • 51-64
  • Over 65

You will be surprised what your data tells you regarding how these demographics pay their outstanding balances. Couple that with a scoring product and you can really develop a strategic work plan for capturing monies from appropriate pay sources and demographics.

3. Use the 80/20 rule to identify your top payers and their payment behaviors.

As a manager and executive, you should understand how these payers are reimbursing you for emergency and non-emergency transportation. This ultimately impacts the bottom line.

There are solutions that can help you manage this process, as well. Solutions Group is a premier RCM solution to help combat the increasing self-pay phenomenon for providers of healthcare.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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