It’s an unsettling reality for many of today’s hospitals: As states continue to implement stricter Medicaid eligibility requirements, more patients may lose their insurance coverage. During a time of extreme financial strain, more self-pay accounts further erodes already slim profit margins. To ensure financial sustainability, hospitals must pursue proactive revenue cycle management strategies to address rising healthcare costs and lessen the financial impact of Medicaid cuts on patients. Supporting uninsured individuals through these challenging times—and helping them navigate the Medicaid cuts on the horizon—enables providers to strengthen collections and reduce bad debt while simultaneously improving the patient financial experience.
The Growing Challenge: Medicaid Cuts and Rising Uninsured Rates
Upcoming Medicaid cuts may soon result in millions losing coverage. More specifically, between 4.6 and 5.2 million adults living in states that expanded Medicaid could lose Medicaid coverage next year under new work requirements. For hospitals, this could equate to higher rates of uninsured visits and increased patient responsibility. The downstream impact of Medicaid cuts on revenue cycle management? Larger self-pay portfolios, longer A/R cycles, and increased bad debt risk.
How Medicaid Cuts Affect Hospitals’ Financial Health
When patients lose Medicaid coverage, revenue cycle management teams feel the impact. Front-end revenue cycle management staff, for example, need to verify Medicaid eligibility more frequently. In addition, with Medicaid cuts, account balances may shift to self-pay, which means revenue cycle management staff must spot cases eligible for charity care, explain financial assistance options, or request deposits (full or partial) at the time of service.
Some patients may also need assistance understanding and navigating ACA marketplace options, including plan selection, premium tax credits, cost-sharing reductions, enrollment deadlines, and provider network differences. On the back-end, post-service patient collection efforts may require nuanced conversations.
Without proactive strategies, revenue cycle management teams may be underprepared for (and overwhelmed by) the scale, volatility, and patient-level disruption Medicaid cuts create.
Taking a Proactive Approach
Taking a proactive approach helps hospitals reduce the emotional and financial stress for patients and provide a better patient financial experience while also safeguarding hospital cashflow. Here are three simple revenue cycle management strategies to consider now—before Medicaid cuts begin:
- Form strategic financial partnerships. Partner with healthcare loan providers to create accessible payment solutions for patients. Many of these loan providers work closely with revenue cycle management staff to facilitate the application process at the time of registration.
- Leverage financial screening. Use front-end scoring segmentation to identify each patient’s ability and likelihood to pay. Then strive to improve the patient financial experience by tailoring outreach, pricing conversations, and payment options (e.g., financial assistance or charity opportunities) rather than applying a one-size-fits-all approach that can quickly make accounts unmanageable and further exacerbate an organization’s bad debt.
- Perform insurance discovery scrubs. Use automated tools to uncover active coverage that might have been missing at the time of registration to prevent accounts from being incorrectly classified as self-pay and written off when active coverage actually exists.
Together, these proactive revenue cycle management strategies help patients maintain coverage or access appropriate assistance while enabling providers to reduce coverage gaps, avoid bad debt, and stabilize revenue as Medicaid cuts unfold.
The Human Difference: The Power of Trained, Consultative Representatives
One of the most important revenue cycle management strategies for today’s hospitals?
Prioritize patient education.
Revenue Enterprises invests deeply in hiring and training representatives who deliver patient-first financial guidance to help patients understand their options, explore coverage alternatives, payment options or apply for charity programs. This personalized engagement during the time of Medicaid cuts builds trust, improves the patient financial experience, and drives higher resolution rates.
Partnering for Long-Term Sustainability
When hospitals partner with Revenue Enterprises, they benefit from cleaner inventory, improved reimbursement, and enhanced community goodwill. Patients benefit from compassionate and clear communication, realistic financial pathways, and a better overall patient financial experience. Together, these efforts help health systems remain resilient amid Medicaid cuts and other policy shifts fueling economic uncertainty.
Looking Ahead
As Medicaid coverage continues to fluctuate, hospitals need a revenue cycle management partner that blends strategy, empathy, and innovation to improve the patient financial experience. Revenue Enterprises stands ready to help your organization adapt and thrive—supporting both your patients and your bottom line.