Shaping the Future of Health Equity & Patient Advocacy
At Patient Funding Alternatives we support the medically underserved Medicaid population through the delivery of health equity-based funding alternatives for the benefit of all stakeholders including patients, health systems, states and employers.
As the gold standard in the country for offering
Premium Assistance Enrollment, we’re committed to a streamlined low-burden process
We’re here from the initial episode of care to assist with the enrollment process and subsequent support services.
We’re responsible for most administrative responsibilities and require minimal patient and hospital involvement.
Providing Comprehensive Services for Patients and Hospitals
Patient Funding Alternatives is the only organization in the country offering Premium Assistance Enrollment and dedicated Patient Helpers (front-line advocates for patients) services to hospital partners.
Patient Helpers
Patient Funding Alternatives’ “Patient Helpers” act as a front-line advocate for patients, and provide additional support to Financial Counselors, Hospital Social Workers, and Case Management teams.
Premium Assistance Enrollment
Working on behalf of the hospital we enroll premium assistance eligible Medicaid patients into employer-sponsored commercial insurance plans through their state’s premium assistance program.
People We Impact
These patient stories highlight how we’ve helped people navigate the often overwhelming costs of medical care.
Securing NICU Care for Premature Twins
“A mother gave birth to premature twin boys, but both twins were medically complex and needed to be admitted into the NICU. One twin was diagnosed with Ventricular Septal Defect and another twin suffered from respiratory distress. Mom was employed at a local hotel at the time of her pregnancy, on 12-week maternity leave, and had access to comprehensive commercial insurance through her job. However, the mother was not enrolled in the insurance as she could not afford the monthly premiums. PFA was able to successfully enroll mom and the twins onto her employer sponsored medical insurance and the family received approval from the state of Georgia into the CHIPRA program.”
Coverage for Lifesaving Care Post Near Fatal Car Accident
“My mother was involved in a near fatal car accident at 51 years old. She is a single mother of two daughters who were 21 and 19 at the time. A few days after the accident, while my mother was still in ICU fighting for her life, I received an email and phone call from a PFA Patient Helper. I didn’t know how she found us but I am so grateful our paths crossed. She explained what the HIPP Program was and how it could be beneficial to my mom and her case. I can’t express enough how much of a blessing it was to have the opportunity for commercial insurance coverage. At the time I was a college student without a job or form of income to cover the costs. HIPP took that burden off of my sister and I.”
Essential Medical Equipment for Child Previously Uncovered by Medicaid
“PFA successfully assisted a father and child enroll in Texas HIPP. The employer sponsored health insurance that the father had access to was cost prohibitive to the family. The father had Veteran’s health insurance that provided single coverage and his child was on Medicaid. The child needed a cranial helmet that Medicaid would not cover. The cost of the helmet was significant, and the family could not afford it. It took several months, but PFA was finally able to enroll the child and father onto employer sponsored health insurance. They now have access to the equipment the patient needs. The family is incredibly grateful knowing that they have additional health coverage for their child’s medical needs.”
Our Process
From engaging with patients to utilizing our proprietary technology and algorithms, we navigate the enrollment journey for each patient, securing commercial healthcare coverage through their respective employers. Once coverage is established, we assist our hospital partners in ensuring they receive maximum reimbursement.
Measurable Performance
Patient Funding Alternatives’s “Patient Helpers” act as a front-line advocate for patients, and provide additional support to financial counselors, hospital social workers, and case management teams.
Approximately
15%
of Medicaid members have access to Employer Sponsored Insurance (ESI).*
* Source: Kaiser Family Foundation Report
Over
70%
of patients remained loyal to their original provider for subsequent visits*
*actual results may be higher due to the inability to track patients with no subsequent visits.
45%
of the time, Patient Funding Alternatives secure’s commercial healthcare coverage for patients interested in pursuing ESI.
On average our hospital partners experience a
3x
lift in reimbursement once commercial coverage is secured.
Trusted by Top Health Systems Nationwide
Patient Funding Alternatives has a growing number of partnerships with leading health systems across a diverse cross section of the United States. Currently, 39 States in the US offer Premium Assistance to Medicaid patients through HIPP. These states are shown in dark purple.