Identifying Medicaid-Eligible Patients
Discussions centering on the American system of health insurance generally focus on costs to the patients. The overall healthcare system, hospitals in particular, also faces costs. In 2005, uncompensated care for hospitals nationwide amounted to $2.8 billion. From 2000 to 2005, these costs increased over thirty percent, according to the American Hospital Association.
One means to reduce these costs for hospitals is to identify patients eligible for Medicaid, recouping otherwise uncompensated costs through the national system administered by states. A number of private firms around the country are developing a variety of systems to determine whether patients qualify for coverage.
According to the Arizona Republic, Phoenix-based Cain and Associations developed software to assess patient eligibility for Medicaid. The proprietary software, the Government Revenue Integrity Program (GRIP) is intended to improve hospital’s receipt of payments from providers. The GRIP system can also be used to connect patients to Medicaid.
Regulations governing eligibility vary from state to state. Most individuals don’t apply for Medicaid until they encounter a need for healthcare services.
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March 9, 2007 Related topics: Finance