Some hospitals have begun to use their ER waiting rooms as an opportunity to sign up patients for the Affordable Care Act, also known as Obamacare. They hope to increase revenue but also to improve patient care and outcome.
The O’Connor Hospital in San Jose, California is one such hospital. Part of the ACA funding in California has gone towards Health Benefits Resource Centers under the Covered California health insurance plan. A representative sits just down the hall from the ER to help patients sign up for and receive benefits if they are uninsured.
Renee Hsai, association professor of emergency medicine at the University of California, San Francisco said, “I think the emergency department waiting room is one of those places where you have low-hanging fruit. They’re not the sickest of the sick because at least someone, the triage nurse, has deemed them stable enough to wait. And if they’re waiting, they might as well be filling out some application form, or least learning about the process.”
O’Connor Hospital sees 5,000 uninsured patients per year. Under the new ACA guidelines hospitals can retroactively bill for up to three months, so signing up an uninsured patient while they’re waiting for care can translate directly to higher revenue for any medical center.
Obstacles for the uninsured
Fifty percent of uninsured adults who could get policies through health insurance marketplaces have never tried to buy insurance on their own. In California, approximately half of adults below the poverty line don’t realize they qualify for Medicaid. Education in this community is needed to help them understand their potential benefits and what the costs will be.
In addition, there has been so much conflicting press about the ACA that many potentially insured don’t know where to begin or what’s entailed. The staff at O’Connor are hoping they can change that by talking to and explaining the process to patients.
What do you think? Is having a benefits specialist near hospital admitting areas a good idea? Do you think patients will see it as helpful or a predatory practice? As a physician were you aware that you could go back in your billing by 90 days for new ACA patients? If you’re an M.D. or D.O. we will be discussing this in more detail inside Sermo, come join us.
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