Uncompensated Care

Reduce uncompensated care and drive appropriate utilization with clinical AI

Strain on the economy has left millions of individuals without means to pay for needed care; while others have chosen to defer seeking care altogether putting them at greater risk for disease progression and inappropriate utilization in the future. As a result of this, hospitals are experiencing significant margin reductions, loss of revenue and imbalance across care settings.

Jvion’s Hospital Financial Recovery suite leverages its’ prescriptive AI and experience to predict patients:

  • Who have deferred care and likely experiencing rapid health deterioration and should seek inpatient/acute care
  • Whose care needs can be appropriately directed to an outpatient or ambulatory setting
  • In an early detection stage for several disease states including Acute MI, Pre-Diabetes, CHF, COPD, Major Depression, Substance or Opioid Abuse and Suicide.
  • With no means to pay but likely qualify for health benefits that will experience a significant acute event at your facility

The insights produced by the Jvion CORE inform outreach, care coordination and management workflows. Knowing where utilization can be optimized is especially powerful for managed populations like commercial health plans, ACOs, and Medicare Advanage.

Key products for Uncompensated Care include:

  • Avoidable Admissions
  • Disease State Early Detection
  • High Cost Utilizers

1. https://www.beckershospitalreview.com/rankings-and-ratings/states-ranked-by-uninsured-rates.html
2. https://www.kff.org/report-section/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act-how-does-lack-of-insurance-affect-access-to-care/

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Featured Product

Accelerating Financial Recovery and Optimizing Utilization with Clinical AI

Since 2000, hospitals of all types have provided more than $660 billion in uncompensated care to their patients. To prevent uncompensated care, the Jvion CORE™ identifies patients that are on a trajectory towards a high-cost inpatient utilization event in the next 6 months, but that do not have health insurance coverage. This empowers hospitals and administrators to proactively guide these individuals to Medicaid or other benefit programs before they end up in the hospital. The CORE also provides insight on the best way to engage with each individual, enabling providers to proactively connect uninsured patients with a financial counselor to explore the best possible insurance options. By identifying at-risk individuals earlier, care teams can drive down utilization, lower costs and improve health outcomes.

Who We Help

Impact Story

Helping a Heart Patient Find Affordable Coverage

When 63-year-old Joe was laid off and lost his health insurance, he was unable to refill the heart arrhythmia medications he took for the past few years. He felt the flutters in his chest, but was hesitant to go to the doctor or hospital because he didn’t have insurance.

After he was flagged by the Jvion CORE™, Joe received a text from the local hospital that treated him for his arrhythmia last year. The message emphasized the importance of not deferring care and the hospital’s ability to help patients find ways to cover their healthcare costs if they have lost insurance or have financial challenges. He scheduled time to speak with a financial counselor about his situation. Joe found out he was eligible for Medicaid, and the financial counselor walked him through the enrollment process. Relieved, Joe reached out to his doctor that previously prescribed his arrhythmia medications, who was able to help him get a new prescription. The doctor explained that Joe was fortunate for calling when he did: without his medication, he could have had a life-threatening emergency that would have sent him to the hospital.

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  • (972) 831-7270 | 222 W Las Colinas Blvd., Suite 2200N Irving, TX 75039
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  • Download the latest SmartFocus paper “The COVID Aftermath: Why behavioral health is the next crisis health plans should be prepared to manage” brought to you by Jvion and SmartBrief to understand why the current state of analytics leave members and health plans exposed to a behavioral health crisis.

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