Overview

PFA helps hospitals enroll Medicaid patients into Health Insurance Premium Payment programs so patients can obtain employer-sponsored or COBRA insurance, with Medicaid as a secondary payer. It uses a national web platform with algorithms to identify eligible patients, and Patient Advocate Specialists guide enrollment and provide ongoing support to minimize burden. It partners with hospitals across the country, including academic medical centers and children's hospitals, and creates revenue for these partners by converting Medicaid patients to higher-reimbursement commercial plans; it is backed by private equity. The goal is to expand access to broader insurance networks and care management for patients while increasing hospital revenue and supporting health equity.