The challenge: Helping patients take advantage of Medicaid expansion waiver
Marcus Day Memorial Hospital (MDMH) is an award-winning rural critical access hospital with 24 acute care beds and 60 providers.
A few years back, when CMS approved Montana’s Medicaid Expansion waiver under the Affordable Care Act (ACA), MDMH embraced the program. Consistent with its mission to provide quality, accessible, personalized healthcare, the hospital wanted to enable patients with incomes below the Federal Poverty Level to enroll in Medicaid and take advantage of Montana’s expansion waiver.
MDMH recognized that establishing a robust Medicaid Eligibility and Enrollment program posed several patient engagement challenges such as managing enrollment, providing financial advocacy, and enabling adequate access to services for beneficiaries. The hospital partnered with Firstsource to successfully manage the complexity and rapidly deploy a patient-centric solution.
The solution: Accelerating patient eligibility and enrolment
Firstsource acted swiftly, deploying its proprietary Patient Advocacy Solution, a blend of financial guidance, technology-enabled services, and program intelligence.
The solution included a two-pronged patient communication approach. Firstsource screened all patients with no medical coverage – those who are inpatient or those with higher dollar outpatient charges. Firstsource then set up a digital patient engagement center to screen patients and offer extended hours support assistance, multiple language support and E-signature solutions.
In close coordination with the MDMH’s Patient Accounting Department and Social Workers, Firstsource deployed customized tech-enabled workflows to optimize Medicaid eligibility identification and enrollment. The tech-infused intelligent workflows, automatically notified advocates when a patient date of service is covered based on the daily eligibility check of all referred accounts against the state’s Medicaid system.
The result: Going above and beyond in Medicaid outcomes
Firstsource’s patient-centric model eased the financial burden and stress of patients. With no implementation fees and start-up costs, the solution has consistently delivered best-in-class Medicaid outcomes for patients and revenue recovery for MDMH. More than 1,000 accounts were able to take advantage of Montana’s Medicaid expansion waiver resulting in a 60% reduction in charity care. This also enabled Marcus Day Memorial Hospital (MDMH) to recover $4M in revenues.