Step Up States- You are Front and Center in the Search for Healthcare Stability

By Infinx
May 8, 2017

It seems that the search for stability is going to be an ongoing theme given the fractious state of Capitol Hill. Even with hirings, firings and the hurricane of news surrounding the ACA, we did find one news item this week that give us a feeling of relief (or least a bit of relief). Perhaps because it seemed reasoned and actually talked about stability in the insurance markets.

A report out of the Center for Health Insurance Reforms (CHIR) at Georgetown University Health Policy Institute caught our eye, published in the CHIR blog. The article was entitled, “New Report Emphasizes States’ Power to Protect Consumers and Ensure Stable Markets in the Midst of Federal Uncertainty”. The report outlined “the potential impact of federal proposals” and how state Departments of Insurance (DOIs) can protect consumers and promote market stability “through their role as regulators and advisors to state and federal policymakers.” In other words, The National Association of Insurance Commissioners (NAIC) is recommending that state regulators counsel policymakers. They should also exercise their regulatory authority “to ensure access to health insurance, promote affordability, and provide high-quality coverage to consumers in their state.”

A stable insurance market for all

It seems to make sense that more insured Americans is better than fewer, so the CHIR conclusion resonates as reasonable: “Today, the uninsured rate is at an historic low. While further reform is needed to ensure more widespread access to affordable coverage, it is vitally important that states maintain and build on the progress made by the Affordable Care Act.”

How much does healthcare cost? What is your zip code?

Modern Healthcare’s article “Healthcare Costs Vary Widely by Region”  reported on a new study that says the best solutions to decrease the high costs of healthcare services “may not be solved at the federal level but in states and their communities”. The report from the Health Care Cost Institute, found that costs of healthcare services “vary dramatically” depending on a patient’s zip code. The study analyzed claims data of employee-sponsored health plans from 2012 to 2014.

  • About 40 million individuals in all 50 states and the District of Columbia who received inpatient, outpatient and physician office care.
  • Services selected accounted for about 65% of total healthcare spending.

The study found:

  • Prices varied by region: Outpatient prices were rose 4.6% in Peoria, Illinois, but rose by 24.3% in Green Bay, Wisconsin.
  • Prices varied by setting: Outpatient services experiences the most price hikes: 8.9% from 2012-2013 and another 6% between 2013 and 2014.

Those who conducted the study said they hope the findings will push state lawmakers, community organizations and patient advocacy groups to investigate why their markets have high healthcare prices.

Revenue cycle management stability is key

What do these headlines mean for all of us? That as the existence of the ACA is dragged from pillar to post across Capitol Hill, people are seeking level ground and stability in order to survive and make sense of things. It looks like states are quickly becoming Ground Zero in the effort to provide market stability and cost reduction. In the meantime,  physicians can find stability by ensuring that they have solid revenue cycle management practices in place. If you know that you can verify insurance while the patient is in your practice, that sets up a process that will foster revenue and improve cash flow. It gives you the ability to conduct preauthorization for treatment, know what your reimbursement will be and set up patient pay.

A solid revenue cycle management system gives you stability and reliability. You don’t really need more uncertainty these days. None of us do.

About the Author



Infinx provides innovative and scalable payment lifecycle solutions for healthcare practices. Combining an intelligent, cloud-based platform driven by AI with our trained and certified coding and billing specialists, we help clients realize revenue, enabling them to shift focus from administrative details to billable patient care.

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