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Case Study
Halifax Health Drives Down Uncompensated Care and Bad Debt
“Change Healthcare brought in qualified professionals and the automation tools that we didn’t have time to develop in-house.”
- Arvin Lewis
Halifax Health, Chief Revenue Officer
Customer
Halifax Health
- 678 beds
- 500+ physicians
- 56 medical specialities
- 117,000 ER visits/year
Challenge
Reduce the cost of uncompensated care and bad debt by helping patients find appropriate funding sources for their medical bills.
Products
Financial Clearance Services
- Eligibility and Enrollment
- Third- Party Coverage
Results
In 2017, Halifax Health converted $69.8 million from self-pay into Medicaid and other funding programs.
The Customer:
Since Halifax Health opened its doors to the community in 1928, the facility has been committed to providing high-quality healthcare using the best talent and latest technologies. The organization is known for guiding central Florida residents and visitors through the growing complexities of healthcare.
Halifax Health has established locations throughout Volusia and Flagler counties including a tertiary referral hospital, community hospital, psychiatric services, a cancer treatment center, the area’s largest hospice, a center for inpatient rehabilitation, primary care ambulatory and walk-in clinics, community clinics, a home healthcare agency, and pediatric practices.
The Challenge: Reduce uncompensated care in a growing self-pay community.
Although many patients want to pay their medical bills, the reality of day-to-day expenses makes it difficult to do so. Healthcare consumers at all income levels are more likely to pay their bills for mortgages, insurance, loans, utilities, cable TV, Internet, lawn care, and newspapers before paying their healthcare bills.1
The same is true for people living in Flagler and Volusia counties. “The average income for individuals is about $35,000,” said Arvin Lewis, Halifax Health, chief revenue officer. “And many of them have a healthcare plan with a $10,000 deductible.” This scenario created a sizable self-pay patient population incapable of paying for medical care and with little knowledge on how to navigate additional funding sources.
Halifax Health decided it was time for a new partner. “I try to work with the vendors that we know will create a great relationship, have a strong reputation in the market, and a durable support infrastructure,” Lewis said.
“With eligibility, we were looking for a company that could seamlessly integrate with our staff and with our processes, and a company that would focus not just on Medicaid but also on Medicare disability and SSI, because that is very important to us,” Lewis said.
“I was personally involved in the search and review, and I made the final recommendation because I knew Change Healthcare would be successful and get the job done.”
“Since 1928, it’s been our mission to care for everyone who comes through the door, regardless of their ability to pay,” Lewis said. “And that means, if you’re living in our market, you’re going to get the same emergency services, the same oncology care, the same behavioral healthcare, the same level of care for all the care we offer.”
With Halifax Health averaging $54 million of uncompensated care each year, the organization knew it needed to decrease expenses or increase net revenue by $10 to $12 million year-over-year to continue meeting its mission.
The Solution: Financial Clearance Services
Due to a lack of internal staff capacity, Halifax Health had outsourced Medicaid eligibility and enrollment services many times. A national provider was able to increase Medicaid and Supplemental Security Income (SSI) eligibility, but Halifax Health still wasn’t meeting its revenue goals or experiencing streamlined operations.
The Change Healthcare staff is part of our family. We treat them like employees because they interact daily with team members in financial counseling, patient access, and case management.”
- Arvin Lewis
Halifax Health, Chief Revenue Officer
“The Change Healthcare staff is part of our family. We treat them like employees because they interact daily with team members in financial counseling, patient access, and case management.”
“We used to spend a lot of time training staff from other vendors, but we didn’t have to train Change Healthcare staff,” Lewis said. “Change Healthcare brought in qualified professionals and automation tools.”
With Eligibility and Enrollment under Financial Clearance Services, Change Healthcare provided expert-trained staff to focus exclusively on qualifying patients for Medicaid, Supplemental Security Income (SSI), and Social Security Disability Insurance (SSDI) as well as assisting patients in submitting applications and enrolling in the right program. They accomplished this while adhering to Halifax Health’s mission and values.
Change Healthcare on-site team members educate eligible patients about their benefits to help reduce or even eliminate their out-of-pocket expenses while helping Halifax Health receive accurate reimbursement.
“Change Healthcare brought us talented and longterm employees who felt very strongly about their company. They blended right in with our culture because we have very long-tenured employees who feel very strongly that Halifax Health is the best healthcare system in the United States,” Lewis said.
After the successful Eligibility and Enrollment onboarding process, Halifax Health deepened its partnership with the Financial Clearance Services solution suite by adding Third-Party Coverage services. The healthcare organization leverages these Change Healthcare services to educate Emergency Department (ED) patients about their motor vehicle accident (MVA) and workers’ compensation benefits. Halifax Health now has on-site professionals to manage manual billing processes, identify compliance with carrier regulations, and optimize reimbursement from complex MVA and workers’ compensation claims.
Outcomes: Change Healthcare delivers real results
“The Change Healthcare staff helped many of our patients get coverage that they didn’t have when they came in,” Lewis said. Patients are now supported as they continue moving through their personal financial journey with healthcare coverage.
Change Healthcare and Halifax Health have been partners for more than 10 years. In 2017 alone, the combined team helped Halifax Health shift $69.8 million of self-pay to Medicaid and other federally funded programs and local agencies. The money saved helped Halifax Health continue providing quality care to its surrounding community.
“At the end of the day, the services we receive from Change Healthcare have helped us generate additional value. They generate payments and the goodwill of our patients. They generate additional SSI days and Medicaid days. So, they deliverwhat they said they would deliver,” Lewis said.
Halifax Health continues to partner with Change Healthcare on other revenue cycle services and technologies due to its ability to deliver results.
To complement the services from Change Healthcare, Halifax Health implemented the company’s Clearance Patient Access Suite application to improve data accuracy, increase patient financial visibility, and empower staff productivity. Utilizing the Clearance dashboard, staff is able to automate eligibility verification, determine propensity-to-pay, generate patients’ out-of-pocket estimates, and initiate pre-authorization screening and verification for all patient procedures. The Clearance dashboard provides at-a-glance information for action across patients‘ records for easy workflow and enhanced performance.
“We’re happy with the service,” Lewis continued. “Change Healthcare is a part of the Halifax family. Their employees act like Halifax employees—they participate in team meetings and morning huddles. Change Healthcare does a good job of always looking towards the future. The longer we’ve had a relationship with them, the more value it brings by getting more patients qualified faster. We look forward to a good and long-term relationship with Change Healthcare.”
Financial Clearance Services
Through the Financial Clearance Services solution suite, Change Healthcare helps hospitals and health systems optimize revenue by guiding patients through the complexities of paying for medical care. The Financial Clearance Services solution suite is ideal for Emergency Departments as well as inpatient and outpatient services.
Our on-site teams:
- Proactively identify and enroll self-pay patients in appropriate government funding sources
- Educate patients on their financial responsibility and devise payment plans, if needed, before their scheduled visits or at the point of service
- Help optimize reimbursement for complex, accident-related claims, including motor vehicle accident (MVA) and workers’ compensation
- Uphold patient satisfaction as well as compliance with state and federal regulations, while helping collect more from patients
1. McKinsey Retail Healthcare Consumer Survey, 2009
