HCMT512 : Health Care Marketing : Payer Mix and Its Roles
Question:
Answer:
Payer mix is a healthcare jargon which incorporates the percentage of revenue originating from private insurance versus those from the government and self-paying individuals. It is essential because Medicaid and Medicare give payments to hospita
ls an amount that is less compared to the actual cost of medication to patients (Pines et al., 2016).
Understanding your payer mix enables you to target reimbursements changes in that, if you realise declines from a payer among your mix, then it's the cause of the reimbursements. The tracking of payer mix changes helps one to notice them easily.
The insurance payer mix in healthcare marketing helps policyholders to predict the future of their agencies in some ways. Firstly through revenue forecasting, one gets to know the amount of revenue they generate from their payers. It enables you to watch the trend of revenue among your payers if it's increasing, decreasing or constant.
Secondly, it helps the healthcare facility to market towards selected payers. Simply, demand towards patients with payers who process insurance claims at a fast rate. It is done by updating the payer websites the necessary information. Reviewing patient's ratings on the payer websites helps to understand and intervene in your failed and succeeded services to patients (Chamberlain-Robert, 2006).
Payer mix generally helps in caring for the sick. The Bible advises us to care for the needy and the sick the way God does to them. Instances in the Bible show that when the sick lacked an advanced medicine, they became weak and unable to work hence their families became poor. In the Book of Mathew 14:14, the Bible says that “…felt compassion for them, and healed they're sick." The payer mix is a typical fulfilment of this Scripture.
The payer mix also enables a healthcare facility to identify new payers. Keeping a good watch on it quickly helps to identify any insurance that may have become a more significant contributor to your business.
References:
Chamberlain, Robert. (2006). Gentlemen--start your engines: When healthcare IT collaborates with hospital marketing, increased profitability is just one of many potential benefits.(Hospital Marketing). Health Management Technology, 27(3), 16, 18-9.
Pines, J., Zocchi, M., Moghtaderi, A., Black, B., Farmer, S., Hufstetler, G., . . . Pilgrim, R. (2016). Medicaid Expansion In 2014 Did Not Increase Emergency Department Use But Did Change Insurance Payer Mix. Health Affairs, 35(8), 1480-1486N.
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