Facing a flood of uninsured patients, many hospitals are turning to outside vendors to help enroll these patients in Medicaid and avoid writing them off as bad debts.
St. Elizabeth Healthcare in Kentucky, for example, uses Firstsource, the new name for a company still better known as MedAssist, to enroll indigent patients, who generally arrive as ED walk-ins, into the Medicaid program and get at least some level of reimbursement for them.
Bill Banks, vice president for revenue cycle and managed care at St. Elizabeth, says the system reached out to Firstsource to do the work because "this is not a hospital's core competency." When a hospital tries to sign up a patient for Medicaid, "there is a lot of push-back to be dealt with," he says. "They may not like the Medicaid label or maybe they don’t like the hassle of filling out a lot of forms."
How patients are signed up
This work, however, is the core competency of Firstsource, a company that provides a wide variety of outsourcing, including in healthcare. Firstsource places its workers right in St. Elizabeth's hospitals, either at admitting or in the ED, from about 7 a.m. to midnight, seven days a week. The hospital's registration clerk identifies candidates for Medicaid or other coverage, such a state "victims of crime" program, and turns them over to the Firstsource worker.
Brenda Snow, executive vice president of strategic planning and analysis at Firstsource, describes the process. "Once the patient is taken care of medically, we get the minimal demographic information from them, hand them a card and ask if they would like to apply for Medicaid," she says.
Anticipating some resistance from the patient, the Firstsource worker talks about the "residual benefits" of the Medicaid card, such as food stamps and pharmacy coverage. Firstsource completes the Medicaid application paperwork, makes an appointment for the patient with a Medicaid case worker and makes sure patients make their appointments, even arranging for transportation is they do not have a car.
Impressive results
Firstsource has contracts with about 800 U.S. hospitals. "We are very successful signing up patients because we know how to do the follow-up," Ms. Snow says. A case study under the company's old name, MedAssist, shows the success rate. Working with MedCentral Health System in Mansfield, Ohio, MedAssist converted 82 percent of total dollars referred to Medicaid or another payment program. Mr. Banks did not have his system's conversion rate at hand. He guessed St. Elizabeth's rate was probably below MedCentral's but is still impressive.
Medicaid is quickly becoming a more important source of income for hospitals, Ms. Snow says. CMS reports Medicaid spending increased 9.9 percent in 2009 and is expected to rise 7.5 percent in 2010. States currently have the option of expanding Medicaid coverage through an enhanced federal match, but under the healthcare reform law, they will be required to provide a higher level of Medicaid coverage starting in 2014. Some 16 million more people will become Medicaid-eligible at that time.
Learn more about St. Elizabeth Healthcare.
Learn more about Firstsource.
St. Elizabeth Healthcare in Kentucky, for example, uses Firstsource, the new name for a company still better known as MedAssist, to enroll indigent patients, who generally arrive as ED walk-ins, into the Medicaid program and get at least some level of reimbursement for them.
Bill Banks, vice president for revenue cycle and managed care at St. Elizabeth, says the system reached out to Firstsource to do the work because "this is not a hospital's core competency." When a hospital tries to sign up a patient for Medicaid, "there is a lot of push-back to be dealt with," he says. "They may not like the Medicaid label or maybe they don’t like the hassle of filling out a lot of forms."
How patients are signed up
This work, however, is the core competency of Firstsource, a company that provides a wide variety of outsourcing, including in healthcare. Firstsource places its workers right in St. Elizabeth's hospitals, either at admitting or in the ED, from about 7 a.m. to midnight, seven days a week. The hospital's registration clerk identifies candidates for Medicaid or other coverage, such a state "victims of crime" program, and turns them over to the Firstsource worker.
Brenda Snow, executive vice president of strategic planning and analysis at Firstsource, describes the process. "Once the patient is taken care of medically, we get the minimal demographic information from them, hand them a card and ask if they would like to apply for Medicaid," she says.
Anticipating some resistance from the patient, the Firstsource worker talks about the "residual benefits" of the Medicaid card, such as food stamps and pharmacy coverage. Firstsource completes the Medicaid application paperwork, makes an appointment for the patient with a Medicaid case worker and makes sure patients make their appointments, even arranging for transportation is they do not have a car.
Impressive results
Firstsource has contracts with about 800 U.S. hospitals. "We are very successful signing up patients because we know how to do the follow-up," Ms. Snow says. A case study under the company's old name, MedAssist, shows the success rate. Working with MedCentral Health System in Mansfield, Ohio, MedAssist converted 82 percent of total dollars referred to Medicaid or another payment program. Mr. Banks did not have his system's conversion rate at hand. He guessed St. Elizabeth's rate was probably below MedCentral's but is still impressive.
Medicaid is quickly becoming a more important source of income for hospitals, Ms. Snow says. CMS reports Medicaid spending increased 9.9 percent in 2009 and is expected to rise 7.5 percent in 2010. States currently have the option of expanding Medicaid coverage through an enhanced federal match, but under the healthcare reform law, they will be required to provide a higher level of Medicaid coverage starting in 2014. Some 16 million more people will become Medicaid-eligible at that time.
Learn more about St. Elizabeth Healthcare.
Learn more about Firstsource.