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Live from HFMA: How One Hospital Steps Up to the Plate with Health Insurance Exchange

June 24, 2014
by John DeGaspari
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Letting an uninsured population know that affordable healthcare is within their reach

Forrest General Hospital, a 512-bed acute care hospital in Hattiesburg, Miss. Serves has instituted an educational program to help its patient population learn about and sign up for health insurance exchange. The county-owned provider facility also manages five other hospitals in the area.

“We have a large number of uninsured population in area, and we felt we needed to embrace the Affordable Care Act to try to educate uninsured people in community, let them know that they probably could afford insurance afford insurance, through the subsidies that are available through the federal government,” explains Pat Riley, the hospital’s director of insurance operations.

The hospital was joined in its effort by Chamberlin Edmonds, a unit of Emdeon, which works with the hospital in the eligibility enrollment arena. It provided patients who were admitted to the hospital with information about insurance exchanges. “We worked with Chamberlain Edwards to identify all of the patients that had received services at our hospital during the prior fiscal year, and we sent information to all of those patients about the Affordable Care Act, make them aware of it,” Riley says.

Chamberlin Edmonds has data on patients that we interviewed for Forrest General, that were over-income or over-assets for the resources for Medicaid during the past year. For people who didn’t meet the disability criteria to qualify for Medicaid, it worked with Forrest General Hospital on crafting a letter to that group of people, informing them that there were opportunities for low cost health insurance.

Mississippi did not create a health insurance exchange, deciding to default to the insurance exchange run by the federal government. Mississippi also was one of the states that did not expand its Medicaid program, so the group that was eligible for the insurance product was not going to be in the population for expanded Medicaid. The hospital became certified with as an application counselor organization, with its name listed on the website. “We got a lot of activity from that,” Riley says. 

To reach out to the communities it serves, Forrest general ran health fairs, town hall meetings, placed educational literature in its facilities and physician offices, and ran public service announcements in local media. 

Riley says the hospital was successful in reaching out to the area’s residents in the initial open enrollment period. “People were skeptical, because they didn’t understand it; that’s why education piece was important,” he says. “ We were much more successful in getting someone to enroll in plan, once they understood it, and you can only do that once you put out the information in a way they can understand it that they will sit and talk with you.”

The main questions that people asked were around cost. Forrest Generalcollest information about income level, number of people in the household and other qualifying information, and ran the information through the federal system to verify the information, and provided them with information about the subsidy they qualified for. Most of the population that expressed interest were from middle age up to 64 years old, Riley says. He adds that he spoke to 200-300 people; of those only 1 percent over the income limit to get subsidy.

The hospital is going to expand the program during the next enrollment period. “We are preparing to schedule meetings in next few weeks, to get the word out on when open enrollment is, so they can get the systems to help figure out what they qualify for,” he says. The hospital is also hiring an additional professional to reach out on the hospital’s behalf.

Of the people who now receive affordable insurance, Riley says: “I got a lot of satisfaction in seeing their reaction, many of whom have not have insurance before. Now they have a good plan for themselves and their families.”

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