Native American children appear along with the words - Medicaid Expansion: Its Effect on IHS Facilities, American Indians, & Alaska Natives

What Does Medicaid Expansion Mean for Indian Health Service Facilities, American Indians, & Alaska Natives?

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EligibilityAdvocates Blog

What Does Medicaid Expansion Mean for Indian Health Service Facilities, American Indians, & Alaska Natives?

Posted on Thursday, July 8, 2021


Medicaid expansion can improve healthcare access for the American Indian and Alaska Native (AI/AN) community in many ways, including by providing health coverage to a larger portion of the population and by increasing third-party revenue for Indian Health Service (IHS) facilities.

Native American children appear along with the words - Medicaid Expansion: Its Effect on IHS Facilities, American Indians, & Alaska Natives

Medicaid expansion can improve healthcare access for AI/AN people and increase third-party revenue for IHS facilities.

Expanding Health Coverage for AI/AN People


As of 2019, an estimated 19.1% of American Indian and Alaska Native people in the U.S. were uninsured.1

Inadequate health coverage is a significant barrier to healthcare access and often causes patients to delay or avoid medical care altogether.

In states that expand Medicaid, more people qualify for Medicaid based on income; so, more members of the AI/AN community become eligible for Medicaid coverage and may no longer be uninsured. This helps remove a major obstacle to healthcare access and enables many AI/AN people to obtain care from other providers in addition to their IHS facility.

Increasing Third-Party Revenue for IHS Facilities


After states were given the option to expand their Medicaid programs beginning in 2014, third-party collections for federally operated IHS facilities increased by 51% from 2013 to 2018.2

During that same timeframe, the percentage of patients at these facilities who reported having health insurance increased by an average of 14 percent, with facilities located in states that expanded Medicaid seeing the biggest increases.2

An increase in third-party revenue in the form of payments from patients’ Medicaid and private health insurance coverage made it possible for IHS facilities to expand their on-site services and lower the need for patients to use the Purchased/Referred Care (PRC) program, while also allowing for an extension in the complexity of services delivered off-site through PRC.2

If your IHS facility is in a state that is or will be expanding Medicaid, you can also expect a boost in third-party revenue as a result. This money can be used toward adding more providers and specialty services, purchasing medical equipment, facility maintenance, and more, all of which will greatly enhance the quality and accessibility of care for your AI/AN community.

Best Practices for Optimizing Self-Pay Conversions & Third-Party Revenue


A patient eligibility and enrollment service can ensure that as many of your patients as possible gain coverage under Medicaid expansion by:

  • Helping patients apply for Medicaid – Eligibility professionals have the resources and expertise to help patients correctly and more efficiently complete their Medicaid applications.
  • Screening patients before discharge – Patients may not realize they qualify for Medicaid, and those who are screened for eligibility and engaged before they leave your facility will be much more likely to follow through with the Medicaid application process.
  • Meeting with patients one-on-one and in person – Face-to-face and personalized engagement with patients results in higher self-pay conversion rates than attempts to assist patients via email and phone alone.

EligibilityAdvocates: Helping IHS Facilities Maximize the Benefits of Medicaid Expansion


Our Patient Advocates work on site to help patients enroll in Medicaid and other health plans or financial assistance programs. By finding alternative funding sources for patients’ medical costs and helping them apply, we can increase your third-party revenue and improve patients’ access to care.

Our services are free to patients and provide a guaranteed ROI for our clients thanks to our performance-based pricing model. We are only paid once we’ve successfully helped you collect reimbursement.

EligibilityAdvocates delivers more self-pay conversions through one-on-one interaction with patients, a pre-discharge screening rate of 90 percent, expanded on-site hours and home visits, advanced technology and screening software, and our expertly trained, compassionate staff who are changing patients’ lives every day.

Contact us to learn more about how we can increase Medicaid enrollment at your IHS facility and help you maximize the benefits of Medicaid expansion.


Sources:

1 United States Census Bureau. “Selected Characteristics of Health Insurance Coverage in the United States.” (2019). Retrieved from https://data.census.gov/cedsci/table?q=Health%20Insurance&g=0100000US&y=2019&tid=ACSST1Y2019.S2701&hidePreview=true

2 GAO (United States Government Accountability Office). “GAO-19-612 Highlights, Indian Health Service: Facilities Reported Expanding Services Following Increases in Health Insurance Coverage and Collections.” (2019). Retrieved from https://www.gao.gov/assets/gao-19-612-highlights.pdf


By Stephanie Salmich

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

11 Statistics on Patient Financial Stress

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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 EligibilityAdvocates