Recently, Washington governor, Christine Gregoire received national attention by announcing her initiative to broaden coverage for the state’s uninsured children. Basically, what she is doing is raising the income limits for the Childrens and SCHIP programs, to allow more families’ children to be eligible. In 2009, her plan would allow for a family of four, earning $62,000 per year to enroll their children into Medicaid coverage. There is a good article on seattlepi.com, here.

One of the parts of the initiative is to reach out to families with eligible children to help them enroll. Who better than hospitals to lead this?

This is a great opportunity for hospitals to mitigate their losses for treating uninsured patients. Also, there is a secondary opportunity within this initiative by Gov. Gregoire that is overlooked: Supplementing coverage for children and families who are having higher and higher out-of-pocket costs from their commercial plans.
There will be many families, it would seem, with working adults who are covering their families with employer sponsored coverage, who will meet the new income guidelines. With this initiative, the out-of-pocket cost could be paid by Medicaid.

The first-line benefit is that providers can bill a secondary payer for high patient balances.

We have been in discussions with a disproportionate share hospital client to consider screening all pediatric admissions for Medicaid/SCHIP eligibility. Even if Medicaid is never billed for an account, the days of the stay can be counted as Medicaid days.

Especially for pediatric accounts, this could equate to $1000 or more, per day of service.

Using this initiative for helping more than uninsured children, but also eligible children with high-deductible coverage would seem to be worthwhile for all hospitals, but especially DSH providers.