Hospitals Must Bolster Patient Financing, Charity Care: Laxmi Patel

With higher volumes of uninsured patients expected under proposed Medicaid reforms, hospitals will need stronger patient financing and charity care programs, according to Laxmi Patel, chief strategy officer at Savista.

In this interview, she recommends hospitals embed front-end financial screenings at registration, offer low- or no-interest payment plans, and make staff communication simple and transparent. Patel points to community-based outreach, including mobile enrollment events and multilingual support, as essential for populations with limited digital access. She also provides real-world examples of strategies that cut bad debt, underscoring the value of proactive planning.

Check out the previous part of this interview, where Patel outlines how Medicaid reforms could raise bad debt and the importance of price transparency.

This transcript has been lightly edited; captions were auto-generated.

Transcript

What strategies can hospitals implement now to strengthen patient financing and charity care programs in anticipation of higher uninsured volumes?

From a hospital and provider standpoint, I think it's really creating the core infrastructure that treats patient financing and charity care as a core from a delivery perspective. The changes that are coming will trigger this continuous coverage churn, so prioritizing early identification and streamlining support is going to be really important. This kind of talks about what I said on AI. Really embedding those front-end financial screenings at the first contact—so scheduling, preregistration, or at the ED [emergency department]—using presumptive care charity approval based on any reliable data that has been available or historical data like tax filings or social determinations is going to be critical.

On financing, hospitals should offer, if they can, zero- to low-interest payment programs so they have payment plans in place and help the population that's going to be impacted to have an opportunity to pay when they're not going to be able to pay the full cost, especially some of those high-cost services initially. Once you have these approaches to the work plan, it gets really important to be mindful and transparent—educating the staff, making it simple so a registrar can explain optionality to the patients within a minute or 2, so it's not these long documents or long structures in place.

The other is maybe scaling and centralizing some of the financial opportunities, maybe looking at community-based outreach, such as mobile enrollment events and multilingual renewal assistance for that population that might not be digitally savvy or have the know-how in how to get information over to you or how frequently they're going to need it, because I think there will be some community programs that can support them from a hospital and bridge it from a patient perspective.

Some of the things that we've seen work are, I can give an example of a Midwestern health care system, which had deployed an ED-based presumptive charity process, which cut their bad debt about 40% in over 2 years. Another system embedding financial navigators into high-volume clinics reduced uncompensated care within double digits. This isn't just about, "Hey, we're going to lose coverage from Medicaid." These are universal strategies that can be deployed right away.