Enhancing Care for the Underserved
Patient Funding Alternatives supports 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.
Benefits
How Does the Patient Benefit?
We believe all families should have access to the highest quality insurance coverage: by partnering with Patient Funding Alternatives, our health system partners help make that a reality for Medicaid patients.
Expanded
Coverage
Commercial Primary,
Medicaid Secondary
Expanded
Choice
Expanded
Provider Networks
Expanded
Services
Access to Specialized Care Management Programs and Out-of-state Provider Coverage
Expanded
Formularies
More Comprehensive
Drug Formularies and Medical Supplies
How Does the Hospital Benefit?
Increased Health Equity
Partnering with PFA can help hospitals meet Joint Commission health equity standards.
Medicaid beneficiaries with additional coverage through state premium assistance programs gain access to larger provider networks and diverse drug formularies, potentially improving health outcomes.
96%
80%
of hospitals report having already established, working relationships or partnerships with community organizations centered on health equity*
Under new health equity standards from the Joint Commission, efforts to improve health equity in the community are increasingly important for hospitals
*Institute for Diversity and Health Equity / American Hospital Association 2019 Report. Reflects respondents with a moderate-to-high commitment.
Improved Financial Results
50%
*Becker’s Hospital Review
$279 Million
Commercial reimbursement rates are often
3x greater
than Medicaid reimbursement rates.
We’re Here from the Initial Episode of
Care to
Assist with the Enrollment Process and Support
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’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.
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.
What is the Process?
We’re Committed to a Streamlined, Low-Burden Process
We are responsible for most administrative responsibilities and requires minimal hospital involvement or support. On average, the process from patient engagement to secured coverage takes 4 – 6 weeks.
Who Do We Serve?
The Medicaid patient population includes medically complex, high-cost cases such as those in the NICU, ICU, pediatrics, transplant, and oncology. These patients often require multiple subsequent visits and continue to benefit from the program even after their initial discharge.
40%
decrease in patients concerned about medical expenses.*
*PFA Member Satisfaction Survey
54%
of families were able to get a previously unenrolled family member commercial insurance.*
*PFA Member Satisfaction Survey
36%
increase in patients’ satisfaction with available prescription drugs.*
*PFA Member Satisfaction Survey
38%
increase in patients’ satisfaction with available Doctors*
*PFA Member Satisfaction Survey