80% of hospitals' self-pay revenue comes from small number of uninsured patients, patient balances after insurance, study finds

Hospitals may be losing significant money if their revenue cycles aren't focused on collecting from patient accounts that are most likely to generate full reimbursement, according to an analysis from TransUnion Healthcare, part of credit and information management company TransUnion. 

The analysis found that 30 percent of uninsured patients or patients who have out-of-pocket costs after insurance generate more than 80 percent of the hospitals' self-pay revenue.

https://ssl.gstatic.com/ui/v1/icons/mail/images/cleardot.gifTransUnion Healthcare said this is important for hospitals to note because the uninsured population and patient balances after insurance have increased. A Commonwealth Fund's ACA Tracking Survey released last May found the number of working-age uninsured Americans grew by an estimated 4 million since March 2017. Additionally, a TransUnion Healthcare analysis earlier this year found patient balances after insurance climbed from 8 percent of the total bill responsibility in the first quarter of 2012 to 12.2 percent in the same period of 2017. 

Although hospitals are focusing more on cost control measures, they "still may be missing the most important part of the picture: an optimized revenue cycle which ensures earned revenue becomes paid revenue," said TransUnion Healthcare.

Dave Wojczynski, president of TransUnion Healthcare, recommended hospitals look at their current approach and determine which patients or accounts are most likely to result in full reimbursement.

"Determining which patients or accounts may present the best opportunities for payment is just one way a healthcare provider can increase their chances of maximizing reimbursements for services rendered," he said. 

Editor's note: This story was updated on Dec. 14. 

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