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How IU Health Slashed Self-Pay by Adding Financial Advisers

News  |  By Christopher Cheney  
   January 05, 2018

Indiana's largest health system has used a 13-fold increase in its financial-adviser staff to drive down the number of uninsured patients by helping them acquire health insurance.

IU Health has slashed the percentage of gross patient revenue that comes from self-pay patients in half over the past six years in large part by increasing the health system’s financial-counselor ranks from 12 to 158.

In 2012, self-pay as a percentage of gross patient service revenue at the

Indianapolis-based health system was 5.46%. In 2016, self-pay had plummeted to 2.85%.

In large part, the counselors help eligible patients navigate a confusing array of possibilities to find a commercial insurance product or government program for which they qualify.

"Ideally, you are reducing the number of self-pay patients and converting more to an insured product, an insured plan, Medicaid payer plans, or Marketplace payer plans," says Angie Church, program manager of individual solutions at IU Health.

At IU Health, the Individual Solutions Department is part of the health system’s revenue cycle corporate division. Its 158 individual solutions senior associates must be state-certified as financial navigators, and they work in several settings across all 15 of the health system's acute-care hospitals, including:

  • Emergency room and inpatient facilities
  • Business offices where uninsured patients are screened for coverage options prior to hospital services, with the screening conversations held via phone calls or at the business office
  • “Back-end” billing offices, where financial advisers help patients try to qualify for coverage after receiving services

Qualifications and Training

When hiring new individual solutions senior associates, compassion is an essential quality that candidates must be possess because the financial advisers collect sensitive personal information, Church says.

"We are getting the medical history, the household size, and family member information. To build a relationship and trust with a patient, where they want to open up to you, there is a certain type of personality that is well-suited to the position."

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.

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