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How Uncompensated Care's Financial Threat Can be Mitigated

By Rene Letourneau  
   April 20, 2015

By providing more payment options and moving away from a "one-size-fits-all" collections approach, one Florida hospital is making progress toward managing the revenue leakage that comes with self-pay patients.

Providing too many services that don't get reimbursed is a recipe for financial disaster for hospitals and health systems. And as more patients move into health plans with a significant self-pay portion, uncompensated care is a growing threat.


Jeffery D. Hurst
Senior VP of Finance
Florida Hospital

"There are lots of areas of revenue leakage, I would call it, as it relates to the services we provide where, unfortunately, we don't always get paid," says Jeffery D. Hurst, senior vice president of finance at Orlando-based Florida Hospital, a not-for-profit health system with eight hospitals and 22 campuses throughout the state.

Hurst cites uncompensated care as Florida Hospital's top revenue challenge over the past several years and says he expects that trend to continue, thanks in large part to high-deductible health plans.

"We have had some relief in terms of the number of patients who were previously uninsured and now have insurance or some type of coverage, predominantly through the open enrollment of exchange products. However, the challenge is that a lot of those patients now have a $3,000 or a $7,000 out-of-pocket obligation. In theory they are technically insured, but until they satisfy that out-of-pocket cost, they really don't have insurance," he says.

Creating Better Patient Engagement

In an attempt to prevent leakage, Florida Hospital has upped its efforts to engage patients in conversations about their medical bill, Hurst says.

"I think uncompensated care will continue to be a challenge for us over the next several years, but it also creates an opportunity for us in the age of consumerism to elevate the conversation and elevate the relationship with patients and to be more proactive and educational in our approach. We are creating collaborative relationships with patients."

Part of that collaboration, Hurst says, is to provide more payment options and to move away from the "one-size-fits-all" approach Florida Hospital has taken in the past to its collections process.

"We have a sophisticated workflow in place to stratify and segment populations based on things like credit worthiness and insurance plans and that has worked fairly well for us. However, when it came to the point of having a conversation with the patient it was still just one approach. They had to pay it all in full. Now we are giving patients different options and letting them choose what works best for them, and that is creating better relationships," he says.

Rene Letourneau is a contributing writer at HealthLeaders Media.

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