Although many of the requirements mandated by ACA were not enacted until 2016, Hospital A was already hemorrhaging under the voluminous paperwork associated with their then manual, paper-driven Charity Care Program, a key component of the IRS mandated Financial Assistance Policy (FAP).
At the time ACA was enacted in 2010, Hospital A had a simple Access database it used for entering and tracking Medical Financial Assistance (MFA) applications. The database had minimal functionality and was essentially an Excel spreadsheet with some very limited data mining capabilities. For the most part, even the simplest tasks required the intervention of the IS department.
Senior leadership grew impatient, regularly asking for more advanced reporting of data metrics that the database simply did not house and the Patient Financial Assistance PFA team did not have the technological know-how with which to create the requested reports.
Patient satisfaction was strained to critical levels as MFA applications went unattended for weeks and even months on end. The PFA team was not meeting target application turnaround times, with over 3,000 MFA applications backlogged at any given time. Paper applications and supporting documents were scattered under desks, in drawers, in spare offices…literally “everywhere”, creating a potential HIPAA violation.
The paper-driven manual process, an inadequate database/management system and heightened demands from senior leadership, all combined, resulted in a burgeoning staff and over-commitment of FTE resources just to maintain an already failing “system”.