Executive Summary
Patient access leaders at Maury Regional Medical Center recouped $330,000 in less than a year with a new financial navigator role. The program connects patients with alternative funding sources.
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Patients often report their biggest concerns are financial.
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About 10% to 20% of patients qualify for assistance from foundations or pharmaceutical companies.
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The financial navigator handles the complex enrollment process.
A financial navigation program started in August 2014 already has increased revenue by $330,000 at Maury Regional Medical Center in Columbia, TN.
“We are reviewing some very out-of-the-box ways to help fund patient responsibility. We have had tremendous success,” reports Rodney Adams, director of pre-service and patient access.
Some patients qualify for alternative funding sources, such as assistance from various foundations or pharmaceutical companies. “But the process for enrollment is complex and very laborious,” says Adams. “This leaves patients confused, frustrated, and tired, not to mention they are still physically sick.”
Patient access leaders started the program to “financially navigate” oncology patients through the nuances of their insurance and identify any possible alternative funding sources. “We dedicated one FTE to financial navigation,” says Adams. “We have seen a tremendous impact on our oncology patient population.”
Adams expects the financial navigation program will net the hospital $500,000 in its first year. Previously, this amount would have been uncompensated care: bad debt or charity. “We also see our disability assistance program netting over $2 million annually,” he says. “And I think there is still more to be recovered.”
“Heavy burden” relieved
Patient access is able to financially assist only 10-20% of oncology patients. “But the ones we can help makes everyone smile,” says Adams. Patient access employees are gratified to tell patients with limited or no insurance coverage that they have secured alternative funding or obtained approval for Medicaid or a plan on the Health Insurance Marketplace.
“We can literally see the relief of a heavy burden being removed from them,” says Adams. “It’s those incredible moments that validate to us that we are doing the right thing, not only for our health system, but for our patients.”
The program has made the hospital stand out in the community, according to financial navigator Amanda Holt. “It’s a brilliant solution that benefits the patient, their caregivers, and the hospital, just by taking an out-of-the-box approach that involves compassion,” she says.
Patients often report their biggest concerns are financial. One stated that the financial navigator “took that burden off my plate and was a blessing during a horrible illness.”
A frequent emergency department patient with a chronic condition can be referred to a disability assistance program. A newly diagnosed cancer patient might express concern over the financial burden of treatments. “We refer those patients to our financial navigator to see how we can help,” says Adams.
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Rodney Adams, Director, Pre-Service and Patient Access, Maury Regional Medical Center, Columbia, TN. Phone: (931) 490-7103. Email: [email protected].
