Healthcare


An Unlikely Sales Force for Health Inurance Marketplaces - Your Hospital

by Patrick Riley 17 Sep 2013
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There has been much written and speculated as to the participation from insurance carriers, brokers, and navigators come October 1st. No one has more stake in the game this fall than hospitals. Some hospital administrators see a rare opportunity to minimize if not eliminate a historically ugly line item on their balance sheet, "bad debt." Or, care provided with no compensation, because a growing number of patients have no health insurance.

Bad-debt for a normal size urban community hospital can approach $60 to $75 million dollars, so any dent in this cost structure is net to the bottom line, and the hospital has no investment cost to bring this phenomenon to fruition. Hospitals are willingly and gleefully setting up call-centers, community information booths, and offering to have representatives talk about the health insurance marketplaces during church fellowship.

It seems community businesses respond to their local hospitals much sooner and with trust than they would with federal or state support for getting the word out. They come to the hospital looking for brochures, flyers, spokespersons and advice.

For-profit hospital chain Tenet Healthcare, based in Dallas, Texas sees the opportunity clearly and has identified patients who have presented in their 49 facilities without health insurance and are actively targeting them to enroll. Tenet has hired Conifer Health Solutions, a hospital financial consultant to place at least one insurance application counselor who is certified under ACA rules in each of its hospitals.

Some analysts are urging this move by hospitals to be seen as smart and potentially problematic for enrollees, thinking hospitals may steer former patients to higher deductibles and coverage they may not need. Others argue, that by getting the uninsured enrolled in some level of access to primary care the cost per capita for healthcare will come down considerably.

Irregardless, hospitals will be a major influence in providing enrollment information and counseling in October as a nation tries to introduce online health insurance marketplaces into our healthcare delivery system.

You can follow me daily on Twitter @Patrick_FrostHC or continue to read my daily blogs dealing with health insruance marketplaces at frost.com. Under the industry verticals on the homepage. Simply click on "Connected Health" under the "Healthcare" heading.

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