Medicaid may be source of untapped revenue

GLOBE NEWSWIRE- Identifying insured patients who are also Medicaid eligible can increase hospitals' revenue recovery from Medicare bad debt by as much as 10 percent a year, according to a new TransUnion Healthcare analysis.

This could mean more than a half-million dollars in recovered, revenue tied to both Medicare bad-debt and Medicaid secondary over a three-year period for the average midsized hospital, the analysis concludes.

TransUnion Healthcare released the analysis earlier this month at the HIMSS19 Global Conference & Exhibition.

The analysis included more than 50,000 cost reports over a 10-year period from more than 100 midsized hospitals with 250 to 350 beds.

Dave Wojczynski, president of TransUnion Healthcare, asserts the analysis confirms what previous TransUnion Healthcare findings showed, which is between 1 and 5 percent of self-pay accounts written off as bad debt actually have billable insurance coverage. That includes already insured patients.

"When hospitals limit their insurance discovery strategy to self-pay patients, they're missing an opportunity to maximize reimbursements from other payment sources," he says. "A complete revenue recovery approach that looks for additional combined coverage for Medicaid, Medicare, and commercially insured patients can increase revenue, decrease costs, and prevent bad debt."

According to the Kaiser Family Foundation, 37 states had expanded Medicaid eligibility as of last month, and it's expected that additional states will expand coverage this year.

Although Medicaid enrollment has gained 11 million more members since the Affordable Care Act went into effect, starting in 2014, there were still 27.4 million non-elderly people without coverage in 2017"This

presents a clear opportunity for hospitals to obtain revenue from patient accounts that may be dual-eligible for Medicaid and Medicare," says Wojczynski.