Humanize and Optimize Patient Payment Options in the COVID Economy

While healthcare can quickly become a medical priority, the resultant bills are unlikely to become a top financial priority—especially when people are faced with other challenges. Many have been impacted economically to varying degrees by the COVID-19 crisis, some acutely as a result of losing their jobs. Others have had income diminished. Still, a majority of people haven’t been impacted. But all of this means fewer balances will get paid in full and patients will need more options to pay over time. A one-size-fits-all approach won’t work. Providers need to tailor the experience to fit the varying needs of their patients.

Start With the Data 

Health systems must sustain revenue in order to continue providing services to their community. For people who can pay their bills in their entirety, we want to encourage them to do so. For those who can’t, we recommend providing flexible payment terms so they can pay over a reasonable amount of time. There is a wide discrepancy in need between these two groups, but both are likely to be found within each city where a health system operates. For example, New Jersey was hit hard by COVID-19. It’s a state with some of the greatest disparity of wealth and income, even within the same zip code. 

To understand the variances in any health system’s service area, it’s essential to segment patient groups first and then segment further within those groups. For health systems to reach patients appropriately and compassionately, we advocate utilizing a minimum of three data sources: financial, demographic, and healthcare. These provide the means to differentiate patients into groups, making it possible to begin developing tailored approaches. 

Group One: People Not Affected

To illustrate the point in a simple way, consider the first group as people who just haven’t been impacted clinically or financially by COVID-19. Thankfully the majority of the population falls into this group. One of the most unique opportunities we have, especially as elective procedures resume, is to push more cash collections to the front end into the pre-service world. For a personalized patient payment strategy at the front end to succeed, providers must produce accurate estimates. As we evaluated the market to solve this challenge, we felt that the best estimate provider in terms of both accuracy and availability was TransUnion. Once an estimate is created, it’s important to establish a payment plan against it, then tie that plan into the entire billing experience. That way, it’s not an inconsistent or dislocated billing experience for patients: the front-end experience is seamlessly integrated into the backend experience.

[Learn more about the unique partnership between VisitPay and TransUnion in the Aite Impact Brief]

Collecting copays won’t be enough to sustain health systems in the COVID economy. Patients will come back for elective procedures—there’s a huge pent-up demand and need. Plus, deductibles have not been hit yet this year. The average balance will go up as these new procedures are arranged. It’s critical to be able to schedule payment plans against those estimates at the time of scheduling or at any point in advance of a procedure. 

Group Two: People Financially Affected

The next group is those who have been impacted financially by COVID-19. Either they’ve lost a job or their income has been reduced in some other way. Patients need information on how they can get relief. Driving online adoption is key for this group so people can access payment relief in an automated and efficient way. Providing relief options through self-service to the greatest extent possible frees up staff to invest their time with the patients who need the most help. 

We recommend making a variety of relief options available for this group. This is a lesson we learned from the past recession: present patients with the relief option that’s right for them, in an automated way, controlled in terms of frequency and availability. Some health systems might want to offer a one-month deferment via self-service, with engagement gated through customer service representatives if patients want more relief.  Another health system may prefer a different approach for their market. We advise our clients on how to best address the particular needs of their patients, and then benchmark the data so it can be analyzed and results can be optimized.  

We suggest encouraging patients to pay within their means, even if it’s a small amount, to keep them involved in the financial process. So, when their job does return or their situation hopefully improves, they can easily increase their payments.

[Watch the HIMSS webinar, “Three Ways to Reduce Cost and Recover Patient Revenue During a Recession”]

Group Three: People Clinically Affected

The last group has been affected clinically. On a relative basis, it’s a much smaller part of the population, and let’s hope that it stays that way. Health systems may provide auto-adjustments for this population under expanded write-off/charity policies; they may also wish to make adjustments to balances owed by family members of people clinically impacted by COVID-19. And they may want to soften finance policies, like interest charges or aging, to continue supporting this community of patients.


We’ve seen from experience that a one-size-fits-all approach to patient payment options hasn’t worked. It’s especially not going to work during a sudden economic downturn. Health systems need to drive online adoption, provide patients with a self-service platform, and be able to offer flexible terms to people in an automated way. It’s more important than ever.

Sustain health systems while supporting patients.

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