EligibilityAdvocates COVID-19 Response - Thank You, ALL Healthcare HEROES!

EligibilityAdvocates COVID-19 Response

| No Comments

EligibilityAdvocates

COVID-19 Response


The coronavirus (COVID-19) is affecting all individuals and organizations in significant ways – physically, emotionally, and financially, to name a few. In addition to creating a national health emergency, more people are out of work and without insurance as a result of this crisis.

EligibilityAdvocates COVID-19 Response - Thank You, ALL Healthcare HEROES!

THANK YOU, from all of us at EligibilityAdvocates!

Thankfully, our patient advocates can continue serving patients during this difficult time. They have been classified as essential staff members and are working on-site to help patients obtain benefits and secure alternative payment methods (including COBRA).

We at EligibilityAdvocates would like to thank all those working in health care who are risking their own safety in order to protect and care for these patients and keep our communities healthy. You are truly health care heroes.

We also want to express appreciation for each one of our patient advocates who is making a critical difference in patients’ lives on the front lines as well.

You are health care heroes too, as you work to minimize the financial impact of this virus on individuals and families.

CMS Waivers


As you may be aware, the Centers for Medicaid and Medicare Services (CMS) issued emergency blanket waivers in response to COVID-19, which have a retroactive effective date of March 1, 2020 until the end of the emergency declaration.

We’d like to draw your attention to these changes in particular, as stated by CMS:

  • 3-Day Prior Hospitalization Waiver for SNF placement – “CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a SNF stay, which provides temporary emergency coverage of SNF services without a qualifying hospital stay, for those people who experience dislocations, or are otherwise affected by COVID-19. In addition, for certain beneficiaries who recently exhausted their SNF benefits, it authorizes renewed SNF coverage without first having to start a new benefit period (this waiver will apply only for those beneficiaries who have been delayed or prevented by the emergency itself from commencing or completing the process of ending their current benefit period and renewing their SNF benefits that would have occurred under normal circumstances).”
  • CAH Length of Stay Waiver – “CMS is waiving the requirements that CAHs limit the number of beds to 25, and that the length of stay be limited to 96 hours under the Medicare conditions of participation for number of beds and length of stay at 42 CFR §485.620.”

States and territories may submit a request for a waiver of statutes and regulations related to Medicaid and CHIP programs using the 1135 waiver checklist; CMS provides these examples of flexibilities they may seek:

  • “Waive prior authorization requirements in fee-for-service programs.
  • Permits providers located out of state/territory to provide care to another state’s Medicaid enrollee impacted by the emergency.
  • Temporarily suspend certain provider enrollment and revalidation requirements to increase access to care.
  • Temporarily waive requirements that physicians and other health care professionals be licensed in the state in which they are providing services, so long as they have an equivalent licensing in another state; and,
  • Temporarily suspend requirements for certain pre-admission and annual screenings for nursing home residents”
Please see the complete COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers document or contact us for more information.

As always, we are here to help you navigate these new regulatory flexibilities and to assist your patients with the financial challenges they may be facing. We are all in this together as we work to protect the physical and financial health of your patients and their families.


 

A couple struggling with patient financial stress seeks the help of a patient eligibility service.

11 Statistics on Patient Financial Stress

| No Comments

EligibilityAdvocates Blog

11 Statistics on Patient Financial Stress

Posted on Wednesday, April 1, 2020

Current research on patient financial stress demonstrates the significant strain that medical bills, health insurance premiums, and healthcare costs place on many Americans today.

In fact, a recent survey of U.S. adults found that more people (40%) fear the medical bills resulting from a serious illness than fear the illness itself (33%).¹

Here are 10 more revealing statistics related to patient financial stress:


1.)  55%The percentage of Americans who worry a “great deal” about the affordability and availability of healthcare. ²

2.)  73%The percentage of U.S. adults who are concerned about their ability to pay for healthcare costs if they become sick or injured. ³

3.)  $500 or lessThe healthcare costs that 42% of Americans can afford before having financial issues. ³

4.)  45% The percentage of U.S. adults who fear going bankrupt due to a major health event. ⁴

5.)  137.1 million The number of Americans who report having medical financial hardship. ⁵

6.)  58% and 60%The percentage of lower-income and higher-income households that consider the cost of medications a stressor, respectively. ⁶

7.)  57% and 56%The percentage of lower-income and higher-income households that view medical bills as a source of stress, respectively. ⁶

8.)  66%The percentage of Americans who are stressed by the cost of health insurance. ⁶

9.)  57% The percentage of Americans who have been surprised by a medical bill that they expected health insurance to cover. ⁷

10.)  82%The percentage of patients who say hospitals are “very” or “somewhat” responsible for surprise medical bills. ⁷

Reducing Patient Financial Stress

A couple struggling with patient financial stress seeks the help of a patient eligibility service.

A patient eligibility service can reduce patient financial stress.


Providing a patient eligibility service can reduce patient financial stress and show them that your facility is here to help.

EligibilityAdvocates’ patient eligibility service reduces patient financial stress by finding monetary sources to help pay their medical bills and by providing them with financial counseling through on-site patient advocates.

Both financial assistance and financial counseling can reduce patient financial stress and the confusion that often fuels it. By instituting a patient eligibility service at your facility, you can ensure that fewer of your patients fall within the statistics listed above.


 

Sources:

¹ NORC at the University of Chicago / West Health Institute – “New Survey Finds Large Number of People Skipping Necessary Medical Care Because of Cost” (2018)
² Gallup – “Healthcare Once Again Tops List of Americans’ Worries” (2019)
³ The Physicians Foundation –  “The Physicians Foundation 2019 Patient Survey” (2019)
Gallup – “Americans Fear Personal and National Healthcare Cost Crisis” (2019)
⁵ Yabroff, K.R., Zhao, J., Han, X. et al. – Journal of General Internal Medicine (2019) 34: 1494. https://doi.org/10.1007/s11606-019-05002-w
American Psychological Association – “Stress in America™: Uncertainty About Healthcare” (2018)
NORC at the University of Chicago – “New Survey Reveals 57% of Americans Have Been Surprised by a Medical Bill” (2018)


By Stephanie Salmich