Impact of Uninsured Population

Solution Preview

In this section we evaluate the overall risk to Presbyterian Hospital of Denton because of an increase in the number of uninsured and underinsured patients. For building organizational strength necessary for meeting these risks we propose five key initiatives. We will explore the extent to which these key measures will address the risk and how it will strengthen Presbyterian Hospital of Denton. Finally, we will examine the capacity of Presbyterian Hospital of Denton to face the challenge of an annual increase of 2-3 % of uninsured and underinsured patients.
? Evaluate the overall risk to the organization if the rates of uninsured and underinsured continue to rise at 2-3% over the next five years.
The overall risk to Presbyterian Hospital of Denton will not increase substantially if the rate of uninsured continues to rise at the rate of 2-3% over the next five years. This is because of two reasons. Uninsured patients are either treated in emergency care or they are admitted to the hospital. Even if the intake of uninsured patients increases in the emergency care by 2-3%, there will not be an increase in risk. Even if the entire emergency area is occupied by the uninsured and they do not pay, Presbyterian Hospital of Denton is capable to supporting the service. On the other hand when uninsured patients are admitted they have to make a down payment called advance payment. This payment is adjusted according to the charitable funds available with Presbyterian Hospital of Denton. When there are no available funds, this advance can be increased to such an extent that it covers the entire estimated cost of treatment. The financial risk is reduced..
The overall risk in case of underinsured patients is high. Almost all insurance plans do not provide full coverage of the hospital bill. There are co-payments and deductibles that must be paid by patients when they are discharged. With increasing number of underinsured persons, there are policy disputes, fee limitation, benefit reductions and out of network fines. . Ordinarily, the policy of Presbyterian Hospital of Denton is that bills should be paid 10 days after the insurance payment is received. Still, the payment is required to be paid by the patient at the time of discharge. The business office of the Presbyterian Hospital of Denton stops patients at the time of discharge ...