Provide a self-pay pricing tool to uninsured, low-income patients and make it work.
“Copa Care” was created. Self-pay prices to be posted on its website for the 10 most frequently requested inpatient and outpatient procedures. The policy was fully implemented in March 2013, making MIHS the first system in Arizona to post their self-pay prices online. In 2014, Arizona adopted legislation , HB 2045, which required providers, including MIHS, to post direct pay prices for at least the 25 most common services on their websites.
Copa Care is a sliding scale for low-income patients at zero to over 200% of the federal poverty line (FPL). Rather than charge full amounts for procedures or doctor visits, which can run into thousands of dollars, MIHS charges smaller payments, as low as a $5 copay.
MIHS also implemented bundled payment options with discounts for patients who prepay to capture lost payments without denying service to those in need.
How has it worked ? The sliding scale has been effective, decreasing self-pay visits to MIHS from 41% in FY 2014 to 22% in FY 2018. Not just reducing self-pay visits, it has benefitted MIHS’ bottom line as well.
From fiscal year 2011 to fiscal year 2016, MIHS saw its operating revenue increase by 28.5%, totaling $722,132,906. Net patient revenue also increased by 14.7%, while bad debt expenses declined by 24.9%.
Healthcare Leaders Media reports MIHS employee education is a key component to effectively publishing discounts and providing price estimates to patients.
Capable record keepers and financial counselors are necessary for a successful roll out of a sliding scale, since they must understand multiple aspects of the payment model and easily explain it to patients at the onset. This was evaluated because of concerns raised by physicians that patients would abandon treatment due to requests for payment at the time of registration.
Nancy Kaminsky, vice president of revenue cycle at MIHS, told HealthcareLeaders Media :
We have a pretty robust financial counseling program up front where we work with the patient, and the sliding scale is actually the last resort. So if we can’t get them enrolled in Medicaid or they don’t qualify for programs like disability, then we’ll work with them to get them in an appropriate category on the sliding scale.