THE CHALLENGE
Wayne Memorial Hospital cares for their rural community, and leadership wanted to do more to help those in need. With almost 18% of their county’s population in poverty and without insurance, many struggled to afford medical care. Leadership’s instincts were right as COVID-19 escalated the need for all patients, especially those without insurance, underinsured with high deductible plans or those who lost their medical insurance. Wayne Memorial’s Financial Assistance Program was put in place to provide funding for those patients. A small staff worked on patient cases, calling foundations and other philanthropic programs for funds to cover eligible patients’ costs, but did this on a per-person basis. They needed help scaling to care for many more patients. This presented a challenge that required staff, extensive search capabilities, tedious enrollment form completion and seemingly continuous follow-up.
Wayne Memorial Hospital wanted a partner that could deliver an end-to-end solution that would fill the gap in their existing medical financial aid reimbursement strategy and offer a holistic approach to managing medical financial aid across their organization. Across different practice areas and teams, Wayne Memorial Hospital needed to address several challenges:• Revenue leakage due to manual processes and inefficient medical financial aid management• Inability to tap into the thousands of available financial aid programs due to the lack of uniformity across health system processes• While their commitment to providing care with compassion, courtesy, and integrity includes a robust charity care program that supports patients in need, the hospital faced escalating numbers of unreimbursed costs for care delivered.
THE SOLUTION
Wayne Memorial Hospital chose Atlas Health as an active partner to deliver an end-to-end financial aid solution that could be implemented easily and quickly – with no capital investment, resources or personnel required. Atlas’ proprietary AI-powered technology and its culture of responsive innovation enabled Wayne Memorial Hospital to move beyond paper-based approaches. A digital automation approach was implemented to ensure all medical financial aid programs are evaluated to help patients access and afford care.To fill all coverage gaps and ensure no patient is left behind or reimbursement opportunity missed, Wayne Memorial Hospital adopted a holistic approach. The hospital has partnered with Atlas to predict the optimal eligible coverage options based on historical EMR data and the results of a simple questionnaire administered at registration. Determining the right financial plan for each patient at registration enables efficient routing of tasks and automation across a wide variety of financial counselors, financial navigators, patient assistance coordinators and customer service representatives
THE RESULTS
In less than a year, Wayne Memorial Hospital helped more than 45 patients afford care with medical aid support. Wayne Memorial Hospital is now on track to support their patients with more than $1 million in 2021, an increase of more than 5x, helping to reduce financial burdens for patients and maintaining financial sustainability for the health system. In a small community, provider and patient overlap are common, and it takes on a new meaning and significance for the care team. Beth Heape, Pharmacist at Wayne Memorial Hospital, said, “We often care for patients who are friends, neighbors, or relatives of our staff members. It’s personal.”
Advanced technology to complete digital and pre-populated financial applications – and digital communications to secure patient authorization and information – have contributed to a 75% reduction in the time it takes to submit a clean claim and a 50% reduction in time to submit a philanthropic aid application. These improvements mean Wayne Memorial Hospital’s financial counselors can help more patients and secure more reimbursements with a more efficient process. Wayne Memorial Hospital’s results demonstrate how partnering with Atlas reduces uncompensated care, increases patient satisfaction and referrals and improves reputation in the community, operating margins and higher levels of compliance.
