News about the millions of Americans, especially children, who have no health insurance regularly makes headlines. It is easy to assume that whatever gaps are currently found in coverage nationwide will be filled in by healthcare reform.
This couldn’t be further from the truth, as indicated by a recent article published in Health Affairs. Completing a study on the utilization of government programs that help pay children’s medical costs, the authors noted that 65% of uninsured children eligible for a state Medicaid or the Children’s Health Insurance Program (CHIP) are not enrolled.
Another study detailing the plight of the uninsured was equally enlightening. The Kaiser Commission on Medicaid and the Uninsured examined the effects that not having medical coverage have on low-income patients’ overall financial and physical well-being. According to the Kaiser Commission’s study, 15% of surveyed adults between the ages of 18 and 64 with medical bills and no insurance indicated they were unable to pay for basic necessities, while 27% said that their out-of-pocket healthcare costs had used up all or most all of their savings.
The study also noted that individuals without insurance are more than twice as likely to delay or forgo needed medical treatment due to concerns about their ability to pay for it. “Delaying or forgoing needed care can lead to serious health problems, making the uninsured more likely to be hospitalized for avoidable conditions,” concluded the authors of the Kaiser Commission study.
Many uninsured individuals could benefit from government programs but are unaware of their eligibility status, unable to navigate the complex application process, or in some cases, too proud to inquire about financial assistance. Help can come, however, from hospitals where these uninsured patients often turn as a last resort.
Hospitals can utilize a strategic combination of communication protocols and eligibility tools that are easily engaged at the front end of a patient’s visit. The net effect of these tools on both provider organizations and individuals cannot be ignored: Hospitals and clinics are afforded a great opportunity to lower their exposure to bad debt while helping their most vulnerable patients receive the critical financial assistance they require.
Beyond that initial visit, patients take their new coverage with them—allowing them to take a proactive role in their future health.
Kirk Reid is the executive vice president and chief marketing officer of Chamberlin Edmonds, an Emdeon company and leading provider of healthcare payment and revenue cycle management solutions.