After stitching you up, hospitals give ‘first aid’ to enrollment

A Swedish staff member helps enroll patients at a December event on First Hill.

By Britt Olson

With the blood flow finally stanched by gauze, glue and several hundred dollars’ worth of stitches, you now sit propped up in a stiff but comforting hospital bed. Your family members survey the damage, and a hospital administrator enters the room, clasping a laptop in her hands. She is there to sign you up for health insurance.

The financial costs of your medical misadventure could tally well over $2,000 for, say, three stitches. That’s why King County hospitals, such as Swedish and UW Medicine, have their staff patrol the ER, approaching the uninsured and eligible with the new options available to them from Washington Healthplanfinder.

Creating teams of assisters

“We have been very proactive at Swedish,” said Tom Gibbon, External Affairs and Community Specialty Clinic Manager. “What used to be 'hospital financial counselors' became patient advocates and 'in-person assisters.'” Swedish now has 25 people dedicated to a Quality Involvement Team at its five hospitals. They help patients manage their insurance options.

Hospitals, including Swedish and Seattle's Harborview, are also identifying patients before they arrive, reaching out to the uninsured by phone and mail prior to scheduled appointments.

“When people call for appointments we remind them that we can help them with that. We try to set them up with a social worker or financial adviser who can enroll them,” said Debra Gussin, Harborview Associate Administrator. UW Medicine has over 200 staff members certified as in-person assisters, covering its four hospitals (including Harborview) and its clinics.

Becoming an everyday event

Many King County hospitals have hosted enrollment events and paired with community partners who offer the same. But as Gussin acknowledges, “This needs to be part of an everyday medical experience, not just a special event.”

Harborview has thousands of uninsured patients and provides over $200 million in charity care a year.

At Swedish, Tom Gibbon said, “Our ER is full of people who don't need to be there, which everyone pays for. Taxpayers are paying for this. That cost is passed on to the public. It will free up our ER for the urgent care and medical emergencies that need to be there. In that way, we will have huge savings.”

Having insurance not only helps guarantee that patients are getting the right care at the right location, but it makes preventive care possible. “If you start intervention on a diabetic patient early on, that person is not using a ton of services down the road,” Gibbon said.

Lost in translation and misinformation

But enrolling the uninsured hasn’t always been an easy sell, especially last fall.

“In the beginning, people said they would do it later. People were hearing a lot of rumors about it, so it was an education issue, rumors that it would be very expensive anyway,” said Gibbon. “When we got people online they were shocked. Pretty soon we had people referring by word of mouth.”

Language barriers and confusion over general insurance terminology are also barriers to enrollment, so translation and education are a major focus for all hospitals. “We have excellent interpreters on hand,” Gibbon said.

Success and expansion of efforts

Harborview has enrolled more than 4,000 people, with the entire UW Medicine group registering 6,000 individuals and families. Swedish has enrolled over 1,600 individuals. Both medical providers have also referred thousands of patients to other insurance enrollment events.

And Harborview has launched a pilot program to explore subsidizing the monthly premiums or copays of Washington Healthplanfinder plans for patients who don’t quite qualify for Apple Health, the state’s form of Medicaid.

“There are still people who fall through the cracks and we are still dedicated to providing care to them,” said Gussin.

Enrolling in a health plan online starts here.