Revenue Rescue: Closing Coverage Gaps to Strengthen Financial Health

Key Takeaways

• Examine how coverage detection has become integral to both fiscal health and operational resilience
• Explore use cases for insurance discovery tools across the revenue cycle, from real-time identification in the ER to post-service safety net applications
• Gain insights from healthcare providers on what’s working, where challenges remain and how to refine strategies for better outcomes

Overview

Healthcare providers face mounting financial pressures, with 1–3% of annual net revenue lost to underpayments and denials, often due to missed or incomplete insurance coverage. Adding to this challenge, the One Big Beautiful Bill Act (OBBBA) is expected to reshape Medicaid coverage, leaving hospitals projected to face $42.4 billion in additional uncompensated care costs by 2034. This increase is driven by newly uninsured patients and reduced Medicaid payments. In this environment, leaving coverage undetected, particularly on self-pay and ED accounts, is no longer sustainable. These gaps not only impact the bottom line, but also increase the burden on patients and staff. Addressing this challenge requires a strategic approach to uncover hidden coverage, reduce revenue leakage and improve financial outcomes across the revenue cycle.