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Case Study: How UCHealth wrote off $26 million in charity care with Patient Financial Clearance

April 11, 2024 by Experian Health

Case Study How UCHealth wrote off $26 million in charity care with Patient Financial Clearance

“I love the availability of the Experian team. They are quick to solve any issue and get you back up and running in no time.”

—Andrew Pederson, Director of Patient Experience, UCHealth

Challenge

UCHealth, in Aurora, Colorado, is an integrated system of 12 hospitals and more than 30,000 employees. When the state of Colorado released data on non-profit hospital charity care and community benefits, UCHealth’s spending was lower than anticipated despite having policies on equitable charity care in place. Additionally, the state was about to implement new legislation on charity care, setting a cap on charges for low-income patients. UCHealth proactively sought to revamp how they handled charity care in preparation for higher patient volumes in the future.

The organization decided to review its charity policy and processes. After examining other providers, UCHealth determined that it lacked presumptive charity functionality early in the patient encounter. New technology would help patients avoid the accrual of unpaid medical bills and keep UCHealth from accruing bad debt.

Solution

UCHealth added Patient Financial Clearance in 2023 after their favorable experiences with Experian Health’s Coverage Discovery®and Insurance Eligibility Verification. Patient Financial Clearance allowed the provider a more nuanced understanding of each patient’s ability to pay by going beyond their reported income to look at the Federal Poverty Level ratio and their propensity-to-pay. The technology used powerful analytics to create a Healthcare Financial Risk Score, encompassing historical credit activities, including payment of past medical bills. Importantly, Patient Financial Clearance helped UCHealth staff determine options for financial assistance automatically, without relying on the patients themselves. Automation in the platform reduces time spent per encounter, improving the patient and staff experience and, ultimately, the bottom line.

Discover how UCHealth secured $62M+ in insurance payments with Experian Health’s Coverage Discovery solution.

Outcome

Thanks to Patient Financial Clearance, UCHealth achieved the following results:

  • $26 million in disbursed charity care.
  • More than 1,700 patients covered.
  • 600 charity cases closed in one month alone (August 2023).

Overall, Patient Financial Clearance helped UCHealth create a more streamlined approach to providing charity care to patients who need it. The technology integrates easily with the provider’s electronic health record (EHR) system, eliminating the back-and-forth between multiple systems during patient registration.

Identifying patients who need financial assistance saves the UCHealth team from misclassifying them as bad debt, minimizing financial losses on the organization while improving their overall experience.

Andrew Pederson, Director of Patient Financial Experience at UCHealth, highly recommends this software and the team that provides it, stating, “I love the availability of the Experian team. They are quick to solve any issue and get you back up and running in no time.” For providers seeking to streamline the revenue cycle, Pederson says, “Get out of your own way and just do it.”

Learn more about how Patient Financial Clearance streamlines patient charity screening while maintaining an outstanding experience at every step of the encounter.

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