The topic of rising deductibles that have come along with the implementation of the ACA is hard to avoid these days. In a report put out by the Kaiser Family Foundation, the average deductible is more than triple what it was a decade ago, which is seven times faster growth than wages have risen in this same period. With such a rapid increase in deductibles, many patients are left a steep and unrealistic amount of hospital fees that they simply cannot pay. We have advised and consulted on this matter quite a bit recently and have determined that this influx of unpaid deductibles going to bad debt or charity is an increased pain point for hospitals and should be addressed similarly to other self-pay accounts.
The good news is that there are recovery solutions that hospital facilities probably already have in place that will certainly help recover some of those at-risk dollars. More than likely, those patients with high out-of-pocket expenses are first time insurance holders who may be in need of more information regarding the aspects of their plan and what is and is not their responsibility to pay. We recommend simply expanding the scope of which your financial counselors are working these accounts. Beyond payment plans, discounts and charity applications, Financial Counselors can be providing much needed education to your patients to help them better understand their bills, the breakdown of financial responsibility and the insurance process. If you have a vendor onsite that provides certified application assistance or ACA Navigator services, ask them to assist with providing educational materials or community outreach activities that assist with relaying this information to your community as well. In addition, you and your financial counselors can begin “front loading” your collections efforts for patients with pre-scheduled services. By arranging payments ahead of the service time, you can offer these patients “prepay” discount’s to ensure you are getting a portion of the patient’s responsibility upfront. “Front loading” can also work in situations where patients have limited plan coverage and need additional program assistance screening from your eligibility vendor.