Blog | Coronavirus

What can providers do as COVID-19 poses increased headwinds to uninsured rate

Blog | Coronavirus

What can providers do as COVID-19 poses increased headwinds to uninsured rate

  • Nine percent of respondents to a recent survey of 328 employers by The Conference Board indicated they will lay off staff in the fourth quarter.
  • Another 2% of employer respondents to the same survey said they plan to furlough staff without benefits.
  • These additional layoffs and furloughs are in addition to those that occurred in prior quarters.

A recent survey of 328 employers by The Conference Board suggests that 9% of respondents will lay off staff in the fourth quarter, while another 2% will furlough staff without benefits. An additional 13% of respondents will restructure, which could result in layoffs.

This is in addition to the:

  • 29% of organizations that have already laid off workers
  • 18% that have restructured
  • 5% that have furloughed staff without benefits

Of the organizations that furloughed staff earlier in the year without benefits, 44% report that the action has not been reversed. Additionally, 42% of organizations that furloughed staff with benefits report that this action remains in place.

The longer organizations maintain furloughs, the greater the risk that individuals will become separated from their organization permanently and lose their insurance coverage.


Survey data from the CDC from prior to the pandemic already show that the uninsured rate was increasing. Approximately 10.3% of Americans lacked insurance in 2019 an almost one percentage point increase from 2018 (9.3%).

Given the increased levels of unemployment relative to 2019, the rate of uninsured is likely considerably higher now. The lack of a COVID-19 relief package in the near term — including support for state and local governments — will likely exacerbate matters if state and local governments have to lay off staff to balance budgets.  

What can providers do to help uninsured individuals

In the face of rising numbers of uninsured, providers will need to have medical accounts resolution processes in place that stress patient education and engagement as early in the process as possible.

Clearly communicating with the patient in advance of service, where possible, or as soon after the provision of service as is practical based on clinical needs, is the right thing to do for patients. It also creates the following opportunities:

  • To identify other sources of coverage as losing job-based insurance typically qualifies individuals for a special enrollment period in the exchanges
  • To educate the patient about the provider’s financial assistance policy
  • To set up a payment plan that meets the patient’s circumstances if no other avenue to satisfy the responsibility is available

HFMA resources available

HFMA’s updated Best Practices for Medical Accounts Resolution provides practical steps providers can take to ensure these crucial communications occur. It also provides a sample financial assistance policy some organizations have used to support their communities during the pandemic. 

About the Author

Chad Mulvany, FHFMA,

is director, healthcare finance policy, strategy and development, HFMA’s Washington, D.C., office.


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