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Financial Navigation saves patients $4.5 million

Financial Navigation saves patients $4.5 million

Patient Financial Navigation saves hospital $2.4 million

Patients of Memorial Hospital of Sweetwater County saved $4.5 million during the last fiscal year thanks to one program – Patient Financial Navigation.

The program was created to help patients and their families address financial needs and to help reduce barriers and stress related to healthcare costs, visits, and treatment.

Patient Navigators Melida Marin and Megan Benedict work directly with each patient to explain and assess obstacles and needs. They help patients understand out-of-pocket expenses, health insurance coverage, and Medicaid/Medicare. They help patients apply for patient assistance programs and offer additional information and other benefits that might be available.

Megan Benedict“We realize a patient’s financial situation can be extremely stressful when it comes to their health. Personal financial hardships sometimes can mean the patient seeks no treatment at all,” Benedict said. “We assist on helping our patients find relief so they can get the help they need and focus on their health.”

Here are just a few of the ways the Patient Financial Navigation team helped patients and the hospital from July 1, 2022, to June 30, 2023:

  • Free medications sent to patients amounted to a savings of $623,412.
  • Free and replacement medications saved the hospital $286,788.
  • Premium assistance through a foundation saved patients $1,559,026 and saved the hospital $779,513.
  • Financial navigators find programs which assist in paying a patient’s co-pay for medication or infusion treatment, saving patients $53,606.
  • Other areas of assistance to maximize insurance coverage for patients saved them $1,312,453. This includes working with Medicaid; Medicare Part A&B, Supplement Plans, and Part D; Social Security Disability; and the Healthcare Marketplace through the Affordable Care Act.
  • Additional community assistance support to the patient amounts to $199,869. This includes connecting and bridging the gap to community resources.
  • The total savings and collected revenues to Sweetwater Memorial through June 30 for fiscal year 2023 is $2,432,360.

Melida Marin“The program has grown by leaps and bounds over the last few years,” Marin said. “It aids every patient – insured and uninsured. Our patients, as well as MHSC, have reaped the benefits of this program since it began.”

A new addition to the program is Medicare outreach for potential retirees. If you’re a patient of MHSC, you might receive a call from one the patient navigators in the six months prior to your 65th birthday. They’ll want to chat with you about Medicare coverage and are ready to help you maneuver through all it entails.

Here’s what else they do:

  • Work with MHSC patients and their families to help reduce stress or hardship related to the financial toxicity tied to treatment and healthcare.
  • Help patients find cost-saving methods for treatments, and improve access to healthcare services the patient needs.
  • Aim to maximize health insurance benefits, reduce economic barriers to care, and accurately explain insurance coverage.
  • Manage, track, and report their interactions to contribute to navigation metrics, ensure providers and staff are aware of ongoing policy requirements, and help to mitigate financial toxicity.
  • Assist with a patient’s economic barriers in care and aid in providing any and all available resources.
For details, call 307-352-8202 or email​