THINK TANK: Uncompensated Care and Coverage Loss: Stress-Testing the Balance Sheet

Coverage loss reaches the balance sheet as bad debt, charity care, and patients arriving uninsured at the same volumes they once arrived insured. As Medicaid disenrollment, subsidy changes, and affordability pressure move more people out of coverage or into underinsurance, exposure can build faster than reserve assumptions and financial-assistance policies were designed for. Effective stress-testing connects the finance model to operating protocols, from eligibility screening to collections posture, so leaders know how much exposure can still be prevented.

This Session Will Examine:

• Modeling coverage loss as a balance-sheet scenario: reserves, bad debt, and days cash under a larger self-pay mix.
• Eligibility screening, presumptive charity, and enrollment assistance as the first line of defense.
• Financial-assistance policy as strategy: where generosity protects mission, and where it hides a fixable coverage failure.
• Collections posture with newly uninsured patients: what is collectible, and what community trust is worth.
• Early indicators that self-pay volume is turning into loss before the quarterly close makes it official.