CHICAGO – Hospitals are seeing an increase in self-paying customers, increasing the stakes for collections and holding the potential to increase days in accounts receivable.
A panel of collection managers from hospitals, speaking at the recent Leadership Summit on Revenue Cycle Innovations in Chicago in late September, said their data indicates more patients are shouldering larger portions of their medical expenses.
Facilities are responding by adopting new strategies to identify and assist self-paying patients and do a better job of collecting at the point of service.
For example, Dallas-based Tenet Healthcare Corp. has seen an increase in uninsured admissions, even as overall admissions have declined slightly, said Jeffrey Nieman, senior director of patient financial services. In the second quarter of this year, uninsured admissions rose 7.3 percent over the same quarter last year, while total admissions declined 2.2 percent.
Over the same period, charity care gross charges are up 9.4 percent and provisions for doubtful accounts are up 18 percent, he said.
At Unity Health System, self-paying patients represent 3 percent of all patients, and self-payment revenue is predicted to rise to $10.5 million in 2007, from $7 million in 2005, said Warren Hern, Unity’s executive vice president and CFO. However, point-of-service cash collections have increased 44.4 percent over the same time period. Also, self-payment days in accounts receivable have dropped 16 percent, to 269.8 days in 2007, compared with 2005.
Unity Health is taking steps to improve staff training, further enhance its Medicaid liaison program and make charity care policy improvements, Hern said.
Self-payments represent about 9 percent of the payer mix of Mercy Health Partners, which operates five hospitals in southwest Ohio.
The number of patients who are uninsured has increased 10 percent to 15 percent, said Yvonne Focke, senior regional director for revenue cycle management. However, the big jump has come in those classified as self-paying with insurance, which has increased 25 percent, she said.
“Technology is helpful in identifying the payer source early,” she said. “We’ve deployed a more robust eligibility system; that means there’s not a lot of chasing on the back end.”