Revenue cycle management specialist Waystar announced it has acquired healthcare financial assistance predictive analytics specialist PARO for an undisclosed sum.
PARO’s presumptive charity solution helps non-profit health systems identify patients who would qualify for charity under a provider’s Financial Assistance Policy, using thousands of sources of socioeconomic data instead of credit scores as an evaluation metric.
The company’s platform also offers evaluation for financial assistance, and ensures legal and hospital compliance, connecting eligible patients with financial assistance instead of sending them to collections.
By determining charity care eligibility and notifying patients, hospitals are able to receive funding from the state and offset what would likely be bad debt, while by receiving information about their charity care eligibility, patients are less likely to feel burdened by healthcare costs.
Why it matters?
Last year PARO identified more than 3.5 million patients as eligible for free or discounted care and reclassified on average nearly a third (30 percent) of what would otherwise be considered bad debt to charitable write-offs.
“Charity determination is an increasingly vital part of the healthcare revenue cycle equation,” Waystar CEO Matt Hawkins said. “Adding this technology to the platform further helps us provide health systems and hospitals with solutions to address their evolving challenges.”
What is the trend?
Under a newly revised state law, which took effect in December 2018, Pennsylvania hospitals should notify patients if they’re eligible for charity care, even if the determination is made without the patient’s knowledge.
Several other states like California and Colorado have similar mandates in place already, and it’s likely many others will follow suit.
Waystar’s platform already allows users to verify eligibility and co-payments, enter patient information, and expedite the patient check-in process by accessing relevant plan information.
The platform, which features a customizable interface, also is designed to help increase POS collections by delivering up-to-date co-payment and deductible information.
Waystar identifies incorrect and under-coded claims, helping protect and uncover revenue with a combination of machine learning and predictive analytics technology, and assists in tracking claims in a health system’s information systems or directly.
The acquisition continues Waystar’s expansion of capabilities for its revenue cycle platform, which it boosted last September with the acquisition of Connance, a provider of workflow driven by predictive analytics solutions.
Waystar added enhanced claims monitoring capabilities a month later through its acquisition of the transaction services business from the University of Pittsburgh Medical Center’s revenue cycle services subsidiary Ovation.
On the record
A 2018 Waystar survey of 500 consumers found that more than two-thirds (68 percent) of consumers had at least some level of social determinants of health (SDoH) challenges, with the most commonly reported issues being financial insecurity and social isolation.
Individuals with high SDoH stress are 50 percent more likely to suffer from chronic conditions and 2.3 times more likely to rate their health as “fair” or “poor”, and patients with high SDoH risk are more than 20 times more likely to miss a medical appointment at least once a month, the study found.
Nathan Eddy is a healthcare and technology freelancer based in Berlin.
Email the writer: [email protected]
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