Are You Ready For The Newly Insured?

The open enrollment period has come and gone, and now hospitals across the country are seeing patients come in with health insurance they purchased on the federal and state marketplaces. Many hospital administrators anticipated the surge of newly insured consumers in need of health care once they had coverage, according to a 2013 article by Becker’s Hospital Review. Some of the biggest concerns many hospital administrators had were seeing a large number of patients with high-deductible health plans, which place larger cost responsibilities on the consumer and could result in lower payments from these patients if they are confused about their coverage, according to the Healthcare Finance Management Association.

Stay prepared for increasing patient volumes
However, Kaiser Health News recently reported much of this hype may have been overestimated as hospitals and health care providers aren’t having significant issues with providing care to these patients just yet. According to an article by Kaiser and USA Today, while patient volumes have risen as expected – one health system that was reported on saw a 10 percent boost in patients already – but the general feeling across the industry is that hospitals and physician practices are dealing well with the additional patients. This may be due to the preparations of hospital executives, as many decided to expand their space and add more physicians to their payrolls. Yet there may be other reasons for this.

Hospitals may still see even more increases in patient volumes as some patients have yet to receive their insurance cards. Health care administrators may experience issues with being able to provide care and collect balances from consumers once the surge begins, David Fleming, president of the American College of Physicians, told Kaiser and USA Today.

“We have not felt the full impact of [the new enrollees] yet,” Fleming said. “We are going to see a substantial increase in volume and it is going to be a problem because there are not enough primary care doctors.”

This means hospital administrators shouldn’t discount the importance of the preparations they have already undertaken. It will be beneficial for many hospital executives to understand the characteristics of these patients. The more hospital administrators know, the better able they will be to handle increasing patient volumes and improve patient collections when the time comes for it.

Here are some quick facts about the newly insured that can help you best prepare for more patients this year and the next:

1. Many are in good health
A 2013 report from PricewaterhouseCoopers determined that 92 percent of the nearly 30 million uninsured people in the U.S. at the time were in good health. In fact, a new report by Gallup found 16 percent of all newly insured consider their health status to be excellent, and 26 percent think their health is very good. Only 15 percent feel their health is fair, and just 6 percent think it’s poor. The majority of patients with new insurance may not have to use their coverage right away or even have high medical bills due to poor health. Instead, most may just need preventive care, which would be covered by their insurance.

2. They have limited incomes
However, many of the newly insured aren’t affluent. According to Gallup, 38 percent of all the newly insured make less than $24,000 a year, and 37 percent earn between $24,000 and $59,999 annually. Gallup noted the majority of the newly insured have lower-than-average household incomes. PwC’s 2013 report forecasted only 56 percent of the newly insured would have full-time employment. For hospitals, helping these patients understand their care costs right at the point of service, such as through a cost estimation, can help them to budget effectively.

3. 1 in 5 speak another language
Easy-to-understand medical bills that are free of medical jargon and complicated lists of services will be important for those patients who are non-English speakers. According to PwC, 19 percent of the newly insured speak a language other than English at home. Communication will be essential for these patients to provide timely payments.

The flood of newly insured may still be coming, but many hospitals have already taken the necessary steps to accommodate these additional patients. However, there are always additional strategies hospital administrators can implement to keep their bottom line healthy.