Few Systems Have Signed Up to be 'Navigators'

Hospitals and medical groups are the organizations that most commonly see uninsured patients and have a powerful incentive to find a payment source. You might think they would play a major role in signing up uninsured Americans for subsidized private coverage through the state insurance exchanges and for expanded Medicaid coverage under the healthcare reform law.

But fewer than 10 hospital systems nationwide are participating as “navigator” organizations and receiving federal grants to help consumers enroll in exchange plan coverage. Some hospital systems and medical groups have received federal designation as certified application counselors, but no data are available on how many. This is seen by healthcare reform supporters as particularly a problem in the 36 states—many led by Republican officials opposed to the healthcare reform law—where the federal government is facilitating the exchanges. States running their own exchanges generally are engaged in more aggressive, better-funded education and enrollment activities.

Observers say the surprising lack of participation by hospitals and physician groups in helping Americans sign up for exchange coverage and the expanded Medicaid program is due to a number of factors. These include lack of information among provider systems about these consumer assistance programs and political pressure not to participate from Republican leaders in many states who are opposed to the Affordable Care Act.

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Source: Modern Healthcare