The Five-Point Plan of Action During COVID-19 

A blueprint to meet patient and provider financial needs in a time of crisis, now and into the expected recession

Through consultation and collaboration with our clients, and leveraging our significant, collective experience in consumer finance, VisitPay has created a blueprint to help providers adapt the patient financial experience during COVID-19. The blueprint outlines five actions to help health systems give flexibility to patients that need it while preserving patient engagement in the financial process, protecting provider cash flow, and finding efficiency in the revenue cycle.

In response to the sudden and soaring level of unemployment associated with COVID-19 and the likelihood that the US economy is already in deep recession, our action plan has been designed to address three challenges. 

First, we expect many more consumers will struggle to pay medical bills and will be unlikely to prioritize them over other household expenses. How can providers continue to engage patients in the financial process? Second, we anticipate a higher volume of inbound calls to provider patient financial services teams as patients seek flexibility in how to manage outstanding bills. How can providers serve all patients efficiently? Third, while many patients will need financial relief, not everyone will. How do providers give support to those that need it, in a targeted, fair, and precise way?

We’ve made over 20 updates to our patient payment platform in the last few weeks to bring this five-point plan to life with our health system clients across the country.

1 Maximize Self-Service

Shifting as many patients as possible as quickly as possible to online payment platforms so that they’re self-servicing will have an immediate and significant impact on both reducing inbound call volumes and maintaining payment rates. Our findings from research with over 3,500 patients documented in this year’s VisitPay Report show that patient preference for paper medical bills has declined 13 points year over year, while interest in receiving an electronic statement by email has risen 36 points. Outbound communication methods and PR can be used proactively to bring patients online, and should focus particularly on those patients most likely to need longer-term financing or with an inclination to adopt self-service tools as part of their healthcare experience. Henry Ford Health System, a VisitPay client, has updated the financial pages of their website with strong and empathetic messages to reinforce the benefits of self-service.

Along with online payment platform adoption, motivating consumers to pay even a small amount towards their balances now or as early as possible is important. This is one way to get ahead of delinquency. We don’t advocate aggressive collection tactics but instead the wider and earlier, but well-targeted, use of payment plans. Adapt electronic billing communications to patients to acknowledge the importance of COVID-19-related economic relief to encourage engagement. Use special alerts both inside and outside the payment platform to make consumers aware of health system COVID-19 policies and longer-term payment options. To encourage the adoption of payment plans, consider offering payment deferrals or holidays (see point 4). 

2 Communicate Purposefully

The unfortunate reality is that many consumers have lost or will lose their jobs. Unemployment claims have soared to over 36 million since the beginning of the pandemic, representing over 20% of the March labor force. Most households don’t prioritize medical bills near the top of their bill payment hierarchy when times are tough. A 2009 McKinsey study, produced in the midst of the last recession, showed only 7% of consumers ranked paying medical bills in their top two household expense categories. As a result, bad debt is likely to increase in both the immediate and near term. 

At the same time, many households have not been significantly impacted by the financial fallout from COVID-19. It is important that health systems communicate billing information in a way that is appropriate for each patient. Use empathy across the billing cycle for those that need help, particularly for accounts already in past due status. Adjusting the tone of dunning messages through the revenue cycle and into bad debt is an appropriate and important demonstration of compassion for families or individuals dealing with financial distress. But keeping revenue cycle messages focused on payment reminders for those not impacted financially is also an appropriate response in the interests of enabling health systems to continue fulfilling community obligations.

3 Make Precise Offers

Third, we recommend adjusting payment terms in ways that reflect individual consumer financial needs as precisely as possible. Score-based segmentation is an effective way of determining which consumers will benefit most from payment flexibility by directly targeting reductions to the patients most needing relief. We also recommend providers turn to new data sources to help them make good decisions in the fast-changing economic environment evolving from the COVID-19 pandemic. Traditional data sources that drive financial assistance decisions are likely to lag and may no longer accurately reflect the economic reality faced by many households. Consider making personalized offers to consumers based on other specific attributes—for example, if a patient has been treated for COVID-19, providers could offer certain discounts or waive particular billing actions. 

With the high adoption of digital self-service tools, the right offer should be made automatically and digitally, making underwriting and loan origination a simple, seamless process for patient and provider. The result should be high levels of engagement in the financial process by providing terms that work for each patient, depending on individual financial circumstances.

4 Target Relief Appropriately

Use score-based segmentation and other targeting based on attributes captured in the payment platform to let some patients skip a payment, known as taking a “payment holiday,” through self-service. Consider enabling functionality to capture the reason for the holiday request. It is important to give some patients the ability to set up self-service payment holidays. It funnels help where it’s needed most, alleviating strain on the call center and leading to higher satisfaction for both staff and patients. But it does not need to be a blanket policy made available to everyone regardless of financial circumstances or needs; this could unnecessarily hinder immediate provider cash flow at a time when it is much needed.

We recommend providing increased flexibility through the call center via customer service representatives, empowering staff with more discretion over payment terms, holidays, and durations. High levels of self-service among the patient population and smart use of data to make the right policy available to the right user will allow staff to focus on exceptions and people who need help with more complex situations.

5 Balance Patient Satisfaction and Payment Rates

As always, the goal of a patient payment approach is to balance patient satisfaction with patient payment rates over time. We measure Net Promoter Score for the billing experience, along with other surveying techniques, to understand whether patients are “likely to recommend” their health system based on the financial experience being offered. We use performance reporting to understand charge and payment trends. During the course of the COVID-19 pandemic, we’ve held several benchmarking sessions with our clients to understand how payment trends have shifted over the last several weeks (you can find some of this information shared publicly by listening to a replay of our webinar with Becker’s Hospital Review). Supplement immediate-term reporting with AI-driven learning loops, helping you continuously make more relevant offers and the most compelling digital payment experience that delights patients.

At VisitPay we’re committed to working with our provider clients to implement these actions. We’ve made over 20 updates to our platform since March and have now made this functionality available for new clients with a rapid deployment, Economic Response Accelerator. We will continue to measure payment rates and patient satisfaction, benchmarking across our clients and across the country in the interests of serving patients while sustaining health system finances. 

If you have questions about our approach please give us a call at 208.343.5035 or send a note:


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