Their first step was to screen as many self-pay patients as possible entering the system, explains Koon.
"Doing this would require us to improve our overall contact rate on our inpatient referrals. We needed the [eligibility and enrollment staff] to see more patients face-to-face. We know that the higher the contact rate, the higher the likelihood that the [insurance] applications get completed and approved," he says. "We were at about 80% in terms of face-to-face time with patients, and we needed to consistently be at 98% to 100%. We were able to do that."
Centra Health worked with its vendor to increase the level of contact and to track it. Koons says that just by increasing personal contacts, the organization was able to reduce uncompensated care from 7% to 5.4%—which accounts for that $9.1 million savings.
Besides the uncompensated care savings, it also increased point-of-service collections by $2 million—from $3.4 million to $5.4 million—for a total savings of over $11 million.
"We've seen a positive shift in our percent of charity as a part of gross revenue and the percent of bad debt," says Koons. "Before we had this robust eligibility program, our bad debt as a percent of our gross revenue was always greater than our charity. We knew we needed to do a better job identifying patients who were truly unable to afford care but could qualify for funding sources instead of allowing them fall under bad debt."