HL20: Gerilynn Sevenikar—Helping Patients Navigate the High Cost of Care

Such comments make her feel terrific, says Sevenikar. "It means we're making a difference!" she exclaims.

Not every patient is happy, of course, nor would Sevenikar expect that. "There's not going to be a 'thank you, Sharp, for sending me the bill,'" Sevenikar says. "That's not happening. There's always going to be some dissatisfaction."

Still, she takes the lessons from 2009, and is carrying them forward. That year, during the economic downturn, Sharp was tested, like many healthcare organizations. Sevenikar says she started seeing steep declines in self-payments, about $3.4 million in one year. At the same time, there was an increase in self-pay volume, about 7%. That coincided, not surprisingly, with a significant rise in San Diego's unemployment from around 8.7% to 12%.

"I did the analysis and it was truly a reflection of the economy," Sevenikar recalls. "People were just feeling the pain. We looked at how we were handling the process with our patients. We wanted to be sensitive to what they were going through. How were we going to bridge the gap for them? What's the right thing to do? What's the reasonable thing to do." Eventually, she says, "We're partners in this process."

One of the ways that Sevenikar believed Sharp could improve payments was to help patients navigate the system better. She began working with Foundation for Health Coverage Education to help patients consider their coverage options. After reviewing data, Sevenikar says that more than 80% of Sharp's uninsured patients are eligible for some assistance.

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