title: Healthcare providers constricted by financial, legislative, and regulatory issues.
abstract: The challenges facing the healthcare industry have created a chasm between the focus on quality of care and financial survival. More than 46.5 million Americans are uninsured, and another 16 million are underinsured with health insurance plans that leave patients unable to afford their portion of hospital charges. There are literally hundreds of solutions to assist hospitals in solving payor, self-pay, billing, and charity issues. Examples of solutions that are available include advanced analytics and modeling, automated decisioning and business rules engines, automated insurance eligibility verification, work flow tools, collection services, patient payment calculators, and many others. As the industry becomes more self-regulated and proactive, the pressure concerning business operations hopefully will diminish and hospitals can focus more on the delivery of care.
authors.affiliation: Healthcare Information Solutions, TransUnion LLC, Westerville, OH 43082, USA. mcallah@transunion.com
authors.forename: Marty
authors.initials: M
authors.lastname: Callahan
mesh_terms: D003695:Delivery of Health Care; D004469:Economics, Hospital / Q000639:trends*; D019981:Health Care Sector; D007348:Insurance, Health; D007882:Legislation, Hospital / Q000639:trends*; D017057:Medically Uninsured; D011787:Quality of Health Care; D017664:Uncompensated Care