How to Operationalize the Consumer-centric Healthcare Vision

operationalize consumer-centric healthcare vision

At this year’s JP Morgan Healthcare Conference, everyone agreed that a person’s ability to pay medical costs should never interfere with their eligibility to receive care. With patients crying out for a better consumer-centric experience, the market has been flooded with patient portals. But are these new user experiences really addressing the provider’s underlying issues?

Forward-thinking CFOs are only just starting to evaluate how technology – and more specifically predictive analytics and segmentation – can be used to manage costs, increase revenue and improve brand loyalty.

Measuring and managing costs

Measuring and managing costs is a recurring theme for the healthcare industry, but it’s not new. CFOs have been worried about measuring and managing costs for a while. Macro trends – the significant increase of high deductible health plans, the cost associated with insurance exchange plans, and consumer’s general difficulty affording healthcare – have long been indicating this was heading our way.

The rise in high deductible plans is making consumers one of the larger payers in the healthcare industry. This isn’t an emerging concept. It’s a bow wave that’s been expected, and now that it’s arrived, executives are exploring ways to tackle the challenge.

Becoming a consumer-centric brand

What is new is the vision of a future where healthcare is consumer-centric. Whether it is a provider, vendor or investor, everyone is focused on building brand loyalty around a better consumer brand. As a testament to how top of mind the issue is, many of last year’s annual reports highlight refreshing the consumer brand as one of the top pillars of a three-year strategy.

In response to consumer feedback, health systems are facing up to who they serve, exploring ways they can treat their patients as individuals, even if care is sporadic. These organizations are making a promise to their community and consumers to become consumer-centric. They are striving to rebrand themselves to ensure they can offer consistent services and experiences based on the population they’re serving. And guess what? People are relating to the promise because they feel they deserve it. As patients, guarantors, and consumers, as people with families and kids – they deserve a better experience when it comes to managing medical expense debt.

According to Kaiser Family Foundation (KFF), more than a quarter of U.S. adults struggle to pay their medical bills, with an estimated 40% of Americans racking up debt resulting from a medical issue. Yet, based on the data we’ve seen, consumers genuinely want to pay their healthcare obligations. There’s a feeling of dignity when we pay your bills. No one wants their bills to end up as unrecoverable debt. But, sometimes that’s the only option when the debt is so substantial there’s no way out.

To manage the high cost of care, consumers go on the open market and secure credit cards they can’t really afford. Cards with high APR percentages attached to them only worsen the experience. That new credit card with an unaffordable line of credit at an unforgiving interest rate can quickly snowball. What happens next? They default on their payment; it hurts their credit score; hurts their standing with the health system; the health system then doesn’t get any cash. The whole bond, loyalty and trust are severed between the two entities.

Putting the consumer in the driving seat

There’s no reason why the relationship between provider and patient shouldn’t feel like an Uber or an online banking experience. During a health event, patients already feel like their environment is out of control. Removing the stress associated with long-term health bills, rather than adding to the pressure – is one-way providers can help patients regain a modicum of control. Putting the consumer in the driving seat creates an experience that can fuel stronger feelings of loyalty and partnership, while also delivering stronger repayment returns.

The good news is providers want to achieve these goals through a nontraditional format. They want to offer patients a consumer application experience versus an archaic billing office and collections agency experience. For many providers, these systems were originally built to engage with government and commercial payers, not patients. What’s less clear is where they start. How they evolve their brands to become more personal? How to achieve this, while also encouraging the communities they serve to feel confident in their ability to take care of their patients’ financial well-being AND clinical health and wellness?

Recognizing the elephant in the room doesn’t make the elephant go away

Branding and relationship building represents a significant part of any healthcare providers’ broader mission to serve their community. Yet to many, serving the community’s health and wellness at the same time as serving their financial well-being still feels like a conflict of interest – misaligned to their higher calling.

How can providers strike the right balance between good finance and health and wellness? Can they adhere to their higher credo while also functioning as a consumer financing organization?  It’s a hard balance to strike – especially when the incentives of different payment models are difficult to follow or are not aligned with the provider’s ultimate objectives. There is no mission without margin.

Transformation creates opportunities and challenges

The healthcare industry’s ongoing transformation is creating challenges and opportunities. On the one hand, providers want to be able to provide a mechanism whereby they can build their brand; build that feeling of trust and loyalty; provide a better experience. They want to do these things because it’s part of their higher calling. On the other hand, they also need to get paid.

To this end, many providers are attempting to modernize their accounts receivable practices. They want to create a beautiful, mobile, simple, inviting, delightful experience between the application and the user. But if the underpinnings of that beautiful experience don’t produce outcomes in the form of cost reduction, patient satisfaction and yield, then what’s the point.

Digitizing the front end won’t magically transform an ineffective process

It’s going to take more than a UI app to solve the problem. Creating an easy consumer application – one that is attractive and easy to use is like applying a band-aid to a broken arm. Unless there’s something behind the application that changes and personalizes the experience, then they’re just beautifying a bad process. If the new experience only offers users a faster way to pay using digitized patient statements and transactions, rather than providing any upshot in terms of the economics, then it doesn’t make much sense.

Creating a front-end that doesn’t address the inefficiencies of a rigid back-end is not going to fool anyone for long. Just because a consumer can see their bill on their phone doesn’t mean the process of accounts receivable has changed. It’s not going to allow the provider to see who is paying their bills and who isn’t; or, who has the potential to pay their bills and who doesn’t. It doesn’t provide them with the analytics tools and models they need to understand what a given patients’ capacity is to pay off a debt. It doesn’t allow them to combine financial data with patient records and clinical data to fully understand the broader picture of an individual patient.

Providers and patients deserve more than lipstick on a pig

It’s no different than if we were operating in a paper world where a patient sits down with a human customer service rep, spends 2 to 3 hours filling out paperwork to see if they qualify to originate a loan, only to be told there are only three options available: (A) 0 to 12 months of 0 percent financing, (B) 13 to 24 months with 2 percent financing or, (C) 36 months with 5 percent financing. It’s the same for everybody, even if none of these options are suitable.

If the system is just digitizing that experience, it’s not really doing anything except making an inefficient process prettier. There’s no innovation, let alone evolution. But if the system automatically, without human intervention, can say “I know enough about this patient to see that none of those three options are very good. Let’s do something that’s a little more meaningful that this patient can afford,” then it’s a game changer. In this scenario, both the patient and provider are the winners.

An evolving vision for consumer-centric healthcare services

Up to this point the market has been enamored with patient portals and digitized payment mechanisms that didn’t use to be there. Although these portals may have helped a little bit in the patient satisfaction score perspective – as it relates to just paying bills, after the solution was in for a long enough time, providers realized that’s really all the portals achieved. The consumer-centric vision is finally coalescing from providers wanting the patient experience to be beautiful, easy and inviting to something more. Chief Financial Officers and Chief Experience Officers want to move the needle beyond portals and digitized versions of paper statements.

Affordable tailored packages that improve patient financial health

The application of segmentation and analytics allows providers to continue offering all their patients the same fantastic quality of healthcare, while also enabling them to tailor repayment packages according to that individual’s ability and propensity to manage that debt. This represents a level of thought leadership where providers are only just beginning to grasp the potential advantages of data analytics.

In this regard, individual providers fall into various levels of maturity when it comes to tailoring finance packages. Forward-thinking CFOs who are only just starting to reach this level of clarity; providers ready to consider tailoring finance packages to individuals based on segmentation and analytics; and providers looking further ahead at how and where they could be using data to improve a patient’s financial health using predictive scoring. It’s not that ‘no-one’ is thinking about analytics and segmentation, but even the few who are, are not sure where to start. They may not even be aware there is technology available that can make what they need possible.

Going from thought leading to activation

Taking the opportunity to lose the rigidity of an old billing system based on an accounts receivable department making decisions with limited information sounds radical, but it doesn’t have to be. What if providers could augment that system with one that is user-friendly at its core – one that can be customized and managed as simply as they would like to, how they pay their bills, where they pay their bills, any level of customization?

VisitPay allows that level of customization – it’s not a one-size-fits-all choice. Thought-leading providers are moving in this direction – where the same healthcare services can be offered to customers on the front end. In this scenario, the amortization of that healthcare benefit becomes a customized package designed to be repaid by the individual. It’s no longer a choice of package A, B, or C.

Delivering better outcomes

VisitPay empowers the healthcare provider and its patients with the freedom to manage the billing process in a way that can help deliver better outcomes.

  • Enabling patients who wouldn’t normally pay their bills, to pay their bills, in a way that gives the patient a positive experience.
  • Providing healthcare providers with the means to offer their patients more than a static set of options which results in patients ending up in collections.

It’s no longer a choice of one way or another. Providers can offer the best healthcare, to the people who need it. They can make that healthcare affordable, in a way that is tailored to an individual patient’s financial situation. And, they can achieve this without a twelve-month deployment cycle.

Let’s take the analytics concept a step further. What if providers could use clinical information as a variable in helping predict what type of financing offer a patient could receive? Take the example of a patient with diabetes. Based on their clinical data combined with their existing financial data, the patient’s condition appears to be deteriorating. The patient’s expenses are likely to get worse in the next few months. Think about how the provider can help the patient get ahead of these circumstances, allowing them to pay before the condition worsens.

VisitPay gives providers a lot of juice for a little squeeze

VisitPay enables providers to be evolutionary. It brings the idea to life from a technology and an interaction between the consumer directly to the health system, without having to introduce massive change to either the operations or IT team. A VisitPay client can be live in 90 days – compare that to IT implementations that average a year or more.

VisitPay offers healthcare providers a time to value comparable to that of an individual buying an app from the app store. Five minutes after downloading the app, the user is buying their airline ticket or ordering a burger from a menu. It’s almost that kind of simple. There’s no huge hunky enterprise licensed software packages that take 12 to 18 months to implement, not to mention the ton of resource time on the provider’s side. Achieving this type of ROI and speed to value – within a 90 to the 100-day time frame is almost unheard of.

Visible benefits:

  • Faster time to value;
  • Tailored financial packages;
  • The same great level of care;
  • Higher percentage of repayment;
  • Minimal to no risk to the health provider;
  • No significant infrastructure changes.

Everybody gets the same level of healthcare. There’s less stress about its affordability because they are offered a customized finance package that suits their situation. It’s what makes that UI front end all worthwhile.

It seems like a no-brainer, especially for a big billion-dollar health system.

To find out what it means for you, start by reading our white paper on the new healthcare economy.

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