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The Elephant in the Waiting Room: Healthcare Organizations Can No Longer Afford to Look the Other Way on Patient Pay

The following is an excerpt of an article by MedData Marketing Manager featured on HIStalk: Healthcare IT News & Opinion:

In the past five years, patient payment responsibility has risen dramatically and continues to increase with the implementation of the Affordable Care Act. More people insured means more people who don’t understand their health insurance and many of the plans on the healthcare exchanges are high-deductible plans. At the beginning of the year, Aetna CEO Mark Bertolini projected patient pay responsibility to climb to 50 percent of the healthcare dollar by the end of the decade.

The New Normal: High-Deductible Plans

Once considered a last-resort alternative for those with limited income, high deductible (HDP) or “catastrophic” plans have gone Fortune 500. As a result, self-pay now includes a lot of the people who have insurance with HDPs.

  • A 2012 Rand research brief estimated that half of all workers on employer-sponsored health plans could be on high-deductible insurance within a decade.
  • The average deductible in employee sponsored health plans was $1,100 in 2013, but deductibles in the healthcare exchanges average between $3,000-$5,000.
  • A report released by S&P Capital IQ estimates that 90 percent of S&P 500 companies will shift their workers from employer-sponsored insurance plans to health exchange plans by 2020.

As more Americans are paying a greater proportion of their healthcare costs out of pocket, getting reimbursed for the patient pay segment could now be the most important number to a healthcare organization’s bottom line. Collecting from patients is estimated to cost up to three times more than collecting from payers. 

Read the rest of the article at HIStalk»

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