SOURCE: PointCare


November 10, 2014 09:54 ET

Obamacare Enrollment Study Offers Providers Eligibility Insight Into Those Still Uninsured

PointCare Findings Help Clients Develop Successful Enrollment Strategies

SAN MATEO, CA--(Marketwired - Nov 10, 2014) - A new study involving nearly 10,000 uninsured Californians seeking coverage during the ACA's first open enrollment offers important information about the uninsured marketplace and insight into how the second open enrollment period, beginning on November 15th, might be more successful.

The study, conducted by PointCare a Silicon Valley-based software company, compares the data collected between October 1, 2013, and April 15, 2014, by two different PointCare clients in California -- a hospital in San Diego, and a federally-qualified health center (FQHC) in Pasadena, CA -- using PointCare's health coverage screening and enrollment tracking software, PointCarePA.

 Key Findings:

  • Age and Gender - The majority of those seeking coverage in the hospital setting were male, (53%) between the ages of 18 and 34 (47%), while those applying through the clinic's outreach efforts were mostly female, (56%) between the ages of 50 and 60 (40%)
  • Eligible for Subsidy - A mere 18% of hospital ER participants were eligible for subsidies from the government for private plans, while 39% of clinic participants reported to be eligible
  • Eligible for Low Cost Public Programs - In both settings, a majority of participants were deemed eligible for a number of public programs; 99% of ER participants were eligible and 80% of clinic participants were eligible
  • Income - Among applicants, 74% in the hospital ER setting earned less than $20,000 per year compared to 54% of applicants in the clinical setting

Highlights of the study are available on PointCare's website:

Given that the Obama Administration has asked providers to take a greater role in open enrollment this year, insight from studies like this offer an opportunity to cater enrollment tactics to be more successful. PointCare's software helps more than 75 provider locations screen for health coverage and track enrollment data.

"Hospitals and clinics can't help but recognize that if 80% to 99% of uninsured Americans will statistically be successful at finding coverage through some kind of government-sponsored program, it pays to be as proactive as possible about enrolling people," said Everett Lebherz, Vice President of PointCare. "Moreover, a look into the significantly different demographics of those showing up to enroll at either an outpatient or inpatient setting can be helpful for both entities seeking to create strategies to better screen and get reimbursed for this population."

PointCare, with roots in the non-profit world, has already assisted its clients with screening more than 670,000 Americans. PointCare's technology was created to engage patients as part of the solution by introducing them to public and private health coverage options that assist with retroactive and future medical costs. The company's clients include hospitals, revenue cycle vendors, and clinics nationwide. For more information, please email

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