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Title	Potential for revenue capture for local public health : an examination of private insurance claims data 2010-2014
Author	Ostafin, Margaret
Date	2018
Affiliation/College	College of Health Professions
Subject.MeSH	Academic Dissertations Academic Dissertations--South Carolina Insurance Coverage Public Health Preventive Health Services Insurance, Health, Reimbursement
Keywords	Private Insurance, Local Health Department
Collection	MUSC Theses and Dissertations
Contributing Institution	Waring Historical Library (MUSC)
Rights	Copyright is held by the author.
Language	English
Type	Text
Format	application/pdf
Media Type	Manuscripts
Resource Identifier	mtd2018_ostafin_m
Abstract	In response to changes in the local public health system driven by budget cuts, funding requirements, and increased costs of providing clinical and preventive services, local health departments (LHDs) are increasingly billing third party payers to generate revenue. Survey and interview data from the National Association of County and City Health Officials (NACCHO) indicate that 90% of LHDs bill third-party payers. Although systems are set up to bill public insurance such as Medicaid and Medicare, there is a paucity of information on billing commercial insurance. This study contributes to understanding the current billing landscape for local public health. A retrospective examination of private insurance data for a five-year period indicates a 123% increase in reimbursement to health departments and an 11% increase in out of pocket costs to clients. Regional variations show that clients in the Northeast paid more out of pocket compared to other U.S. regions. Additionally, reimbursements to health departments were higher in Medicaid expansion vs. non-expansion states.

Potential for revenue capture for local public health : an examination of private insurance claims data 2010-2014

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