Patient advocate organizations, whether state-run, not-for-profits or for-profits, can shave millions of dollars a year from hospital and medical bills, the Wall Street Journal reported.
One organization, the Patient Advocate Foundation, used some 200 caseworkers to reduce patient medical debt by $48 million, according to the Journal.
Moreover, the Affordable Care Act has furnished $58 million in grants to help states establish patient advocacy agencies. About two dozen states established such organizations. In Connecticut, the agency saved patients $9.6 million last year and $50 million since 2001, mainly by disputing medical bills and getting insurers to cover care previously deemed medically unnecessary. It takes on 98 percent of the cases that come its way.
Patient advocates can also wipe out facility charges levied by more and more hospitals, particularly if the patients weren't notified in advance, according to the article.
Advocates are sorely needed for patients; although the ACA capped out-of-pocket costs at $6,350 a year for individuals and $12,700 for a household, that is often more than many Americans are financially prepared to pay, according to MarketWatch. And that often does not even include charges for out-of-network providers. Meanwhile, out-of-pocket costs continue to rise even as healthcare inflation remains low.
More than half of Americans would need to borrow from their retirement funds or use a credit card to pay for sudden medical expenses, and nearly half have less than $1,000 on hand to deal with such expenses, according to a recent study by the disability insurer Aflac.
For-profit patient advocacy businesses also exist, with the major difference being that they charge for the services. Their rates range from $55 to $200 per hour, according to the Journal.
"We would like to be able to say to people that insurance and healthcare are not complicated, but they are," Victoria Veltri, Connecticut's healthcare advocate, told the Journal. "If you can't figure something out and it's an urgent medical situation, call early."
To learn more:
- read the Wall Street Journal article
- here's the MarketWatch article
- check out the Aflac study (.pdf)