MHSC Financial Navigators help patients save money

MHSC patients get help navigating their way to $11 million in savings

Patients of Memorial Hospital of Sweetwater County collectively saved more than $11 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 Financial Navigators Melida Marin and Megan Benedict work directly with patients 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.

A lot of people have benefited from the program, said Patient Financial Services Director Ron Cheese.

“There are people who have seen the light at the end of the tunnel when they had no hope,” he said.

The program is remarkable, Cheese said. So remarkable, in fact, that a third financial navigator is being hired.

Other Wyoming hospitals have taken notice and want to learn more about how Patient Financial Navigation works. They want to know how MHSC has saved its patients money when it comes to healthcare spending.

“Empowering, encouraging, and empathizing with our patients from the start of their care and beyond, to be an advocate is the most rewarding part of being a Patient Financial Navigator,” Benedict said. “My goal is to educate patients, so when they leave my office they feel empowered to take more control of their medical finances and have a better understanding of their coverage.”

Here are just a few of the ways the Patient Financial Navigation team helped patients and the hospital from July 1, 2023, to June 30, 2024:

• Free medications sent to patients amounted to a savings of $726,365.
• Free and replacement medications saved the hospital $654,627.
• Premium assistance through a foundation saved patients $3.05 million.
• Financial navigators find programs which assist in paying a patient’s co-pay for medication or infusion treatment, saving patients $84,492.
• Other areas of assistance to maximize insurance coverage for patients saved them $6.5 million. 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 $110,129 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 2024 is $3.6 million.

Marin sees it as a moral obligation to help educate patients on insurance coverage.

“We have seen patients experience the unfavorable end for not having the right coverage or simply being underinsured. In many cases that could have been prevented if they only knew or we could have caught it on time,” Marin said.

The latest addition to the program is Medicare outreach for potential retirees. Regular Medicare education workshops hosted by the navigators have been successful in helping area residents navigate the changes to their health plans. Upcoming programs are scheduled at 11 a.m. Oct. 10, 6 p.m. Nov. 7, and 11 a.m. Dec. 5 in the hospital classrooms.

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 the navigators 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.

“We believe it is important to make an informed decision when it comes to your healthcare,” Marin said. “Many illnesses can be prevented or treated if caught early. Having the tools necessary to make the best decision possible can make a world of a difference.”

For details, call 307-352-8202 or email patient_navigation@sweetwatermemorial.com.​ To find out more about this and all Sweetwater Memorial has to offer, go to sweetwatermemorial.com.