Hospital revenue data shows growing financial risk from self payers: 3 takeaways

National accounting firm Crowe Horwath's benchmarking report for the second quarter of 2015 builds on first-quarter data, but highlights the growing financial risk posed by the newly insured self-pay patient population that has sprung up due to the adoption of high deductible health plans. 

The quarterly Crowe Revenue Cycle Analytics Benchmarking Analysis examined patient account transactional data from 444 hospitals through June 30, 2015.

Here are three takeaways from the report.

1. Based on month-end figures between June 2014 and June 2015, total accounts receivable from insured self-pay patients increased 13 percent in the past year. Total accounts receivable over the same time period from uninsured self-pay patients decreased 22 percent, mostly as a result of high financial-risk patients joining Medicaid in expansion states.

2. The percentage of self-pay insurance accounts receivable aged beyond 180 days increased by 2 percent between June 2014 and June 2015. Another increase was in the average account balance, a 1 percent increase to $654 in June 2015.

3. The average amount of non-point-of-service payments made more than four days, but within 90 days after the date of service remained a constant $235 from the first quarter of 2014 to the first quarter of 2015.

"The replacement of traditional health plans with HDHPs is creating more patients who are not only newly insured, but who bear significant financial responsibility via co-pays and high deductibles," Cory Herendeen, a principal in Crowe Performance Consulting, concluded in a news release. "This has created more financial risk from the insured self-pay population."

In the report, Crowe Horwath recommended healthcare organizations track self-pay patient collections, as the performance varies for uninsured and insured patient sources.

That will help facilities better identify opportunities to collect insured patient co-pays and deductibles, Crowe Horwath said. In addition, the group said, benchmarking provider self-pay patient collections to similar organizations "will provide additional insight into performance and identify areas of opportunity to drive organizational strategies and improve financial performance."


More articles on healthcare finance:

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Tufts Medical Center Q3 profits plummet
Iowa providers call state Medicaid privatization plan too aggressive


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