More Uninsured Americans for First Time in a Decade
The number of uninsured patients rose by nearly two million people in 2018, according to the latest U.S. census figures. This is the first increase of its kind since 2009, when the Affordable Care Act took effect.
In 2018 the total uninsured rate was 8.5 percent, compared with 7.9 percent in 2017.
Drop in Medicaid Coverage
The increase in uninsured is surprising because of the strong U.S. economy and low unemployment rate. Census officials believe the upturn may be primarily due to a corresponding drop in Medicaid coverage. Total Medicaid coverage dropped by 0.7 percentage points, an enrollment decrease of about two million people.
By contrast, the number of people covered by private insurance didn’t significantly change.
But pinpointing the exact cause for the decline in coverage is not so simple.
For one thing, there’s the cost factor. The 2018 average premium for an ACA benchmark health plan (not including premium tax credits) was about 34 percent higher than it was in 2017, according to a report by the Congressional Budget Office.
In addition, some people may have voluntarily dropped their coverage once the Trump administration repealed the ACA’s individual mandate. That repeal ended the requirement to buy insurance or pay a penalty.
The number of uninsured children also increased, according to the census report. Last year, 4.3 million children did not have medical insurance — an increase of 425,000. Children living in the South and Hispanic children were the most likely to be uninsured.
In addition, there were persistently high uninsured rates among the poor in states that have opted out of Medicaid expansion. For these 14 states – most of which are located in the South — more than one-third of people living in poverty lack health insurance.
What It Means to Healthcare Providers
Most healthcare providers know that the cost to collect on a self-pay account is up to three times higher than on a commercial insurance account. Of course, the longer a self-pay balance remains unpaid, the lower the probability of collecting.
With the increased number of uninsured patients, along with rising healthcare costs and more high-deductible insurance plans, the problem is not likely to go away anytime soon.
But there are a few things medical providers can do to increase collectability on self-pay accounts:
- Counsel patients on their payment options and develop payment plans that allow them to pay their balances over time, when necessary.
- Allow insured patients to take advantage of self-pay discounts, if they choose to do so.
- Provide your patients with online access to their accounts so they can see what their insurance has covered, verify recurring payments and make payments anytime and anywhere.
- Consider outsourcing your business office to a collections partner that specializes in healthcare financial services. Outsourcing these functions provides the following benefits:
- Allows providers to concentrate on providing quality patient care.
- Reduces billing errors.
- Saves money by reducing overhead.
- Improves cash flow.
- Ensures billing compliancy (e.g., with Medicare, Medicaid or third-party payers).
- Ultimately improves patient satisfaction.
Wall Street Journal