Through outreach efforts, hospitals can help connect the uninsured to coverage and reduce uncompensated care.
The Patient Protection and Affordable Care Act presents new opportunities for uninsured Americans to get health insurance coverage through the state-based and federal marketplace and expanded Medicaid programs in states that have chosen to extend eligibility. In his State of the Union address, President Barack Obama said 9 million people have signed up for private health insurance or Medicaid under the healthcare reform law.
However, limited healthcare literacy can stand in the way of those seeking coverage. A recent Kaiser Family Foundation report examined consumers' and enrollment assisters' experience with enrollment in the state-based exchanges and Medicaid in Maryland and Nevada. Both states opted to expand their Medicaid programs this year to cover adults earning as much as 138 percent of the federal poverty level.
Kaiser Family Foundation analysts found that although consumers in Maryland and Nevada are highly motivated to get health insurance coverage, many need help understanding the marketplaces, the options available to them and health insurance in general.
"Some assisters noted that they often spend time upfront explaining how the marketplace works, that financial assistance may be available, what coverage options exist and answering broader questions about the [PPACA]," the report's authors wrote. "In some cases, they also have to provide a basic explanation of what health insurance is, particularly for consumers from other countries who may not have familiarity with the concept of insurance and for those that have not had insurance for many years."
These findings underscore the need for outreach and education efforts to aid the uninsured in getting health insurance under the PPACA.
"This is especially important for groups who are less likely to enroll," says Jessica Stephens, a policy analyst with the Kaiser Family Foundation and one of the report's authors. "That runs the gamut from young adults to those with limited English proficiency and just the general population."
Previous research from the Kaiser Family Foundation has shown healthcare providers can serve as an important link to coverage for the uninsured. A study of one-on-one Medicaid enrollment assistance through community health centers in Utah found children in families who received assistance were more likely to enroll in coverage and to use preventive care services than those who didn't receive help in signing up.
Ms. Stephens says a large share of families learn about their healthcare options through their providers, which they view as a "trusted resource." In addition to helping patients, engaging in education and outreach efforts to assist the uninsured in getting coverage has positive effects for hospitals and health systems as well. According to the American Hospital Association, community hospitals posted $45.9 billion in uncompensated care in 2012, which accounted for 6.1 percent of total hospital expenses. Therefore, "from the perspective of the health system or the hospital, it gives them an opportunity to claim payments for services that might otherwise be uncompensated care," she says.
Overall, hospitals, enrollment assisters and others will have to pitch in to make the PPACA reforms effective in extending health insurance coverage to many of the nation's uninsured, reducing the burden of high healthcare costs for everyone.
"For many people, this is confusing," Ms. Stephens says. "Health insurance is confusing in general. Outreach to different communities is essential in letting people know that these new options are available."
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