Abstract: Tackling the challenge of optimizing payment of patient balances requires health systems to differentiate between standardizing workflow and the creation of a true consumer-grade experience by employing specific software, coupled with marketing and consumer finance know-how. No single vendor can solve every business problem. The best hope is to find a solution that leverages the EMR seamlessly and provides the patient and provider with an integrated view.
The challenge of using only the EMR to optimize consumer financial payments
We all know that patients have become vital payers for health systems. Over 40% of consumers choose a high deductible health plan today, but almost half of the adults in the country struggle to pay a significant unexpected bill of more than $400, and are likely to pay medical bills last. Consequently, many health systems now budget annual increases of 6% to 7% in bad debt write-offs.
Understandably, many CFOs are turning first to EMR portal and revenue cycle software to address the challenge. Unfortunately, it’s not enough to meet the varied expectations of the patient consumer. As Atul Gawande wrote in his New Yorker article: “Why can’t our EMR systems be like our smartphones – flexible, easy, customizable? The answer is that the two systems have different purposes. Consumer technology is all about letting me be me. Technology for complex enterprises is about helping groups do what the members cannot easily do by themselves – work in coordination.”
In a nutshell, Dr. Gawande’s statement echoes the frustration that health system CFOs may feel about the investments they are making in EMR technology. The consumer plays an ever-growing role in healthcare. It is one of the reasons why CFOs can’t always default to “Epic gets first right of refusal, and more functionality is coming in the next release” or “We already have it in Cerner.” Tackling the challenge of optimizing payment of patient balances requires health systems to differentiate between standardizing workflow and the creation of a true consumer-grade experience. Their frustration lies in finding a suitable solution that combines the marketing and consumer finance know-how necessary to engage the consumer with the ability to tackle the complexities associated with healthcare billing.
Increasing the value of an existing EMR investment
Over the past decade, it’s become pretty clear that investing and implementing an integrated, high caliber EMR-revenue cycle system like Epic is critical to optimizing compliant third-party insurance company reimbursement. For CFOs, such systems are a game changer because they enable the health system to manage the patient journey from the first clinical encounter through to resolution of the final bill. An integrated EMR system marries both the clinical and the financial elements of the journey.
What most CFOs have also learned is that no single vendor can solve every business problem. The best hope is to find a solution that leverages the EMR seamlessly – one that provides both provider and patient with an integrated view. Even if your system happens to have Hospital Billing (HB) and Physician Billing (PB), and you’ve also taken the step to upgrade to Epic’s Single Business Office (SBO), integrating a solution that is attuned to consumer financing needs is a springboard to creating a self-service, digital patient billing experience.
5 ways VisitPay and EMR integration can optimize consumer financial engagement
When it comes to paying out of pocket obligations, patients think like consumers, familiar with managing their finances online or shopping online through Amazon.
Following is a table that summarizes the differences between using an EMR like Epic only vs. enhancing the EMR with a dedicated consumer platform like VisitPay. It helps to illustrate the key areas where consumer credit is best addressed with a specialized partner.
#1 Transparency of patient liability
Having transparency of patient liability is beneficial to both the patient and the health system. It is not that patients trust their insurer more than their provider, but seeing an accompanying EOB (Explanation of Benefits) from the insurance company – which shows the patient what they owe and why – increases the credibility of the provider’s statement. If the patient receives their EOB separately, they may not view both documents side-by-side.
#2 Standard billing vs. patient-driven workflows
To facilitate the needs of the patient as a payer it’s critical to differentiate between patients. This ability is foundational to creating a consumer-friendly billing experience. While the EMR may not enable patient-driven financial workflows, VisitPay is built to bring them to life. This is an integration area where VisitPay dovetails perfectly with the EMR, complementing it by enhancing the consumer channel, offering patients more opportunity to see the entire landscape of options across the revenue cycle to settle a bill.
#3 Enhance credit and collection policy
For health systems using the EMR only, credit and collection policy capabilities go as far as determining how many statements a hospital will send and offering digital bill-payment options. In contrast, integrating VisitPay with the EMR enables a health system to bring to life sophisticated credit and collection policies in an online, self-service manner. Creating a more sophisticated credit and collection policy enables health system to encourage consumers to act in ways that work for both themselves and the health system, and deliver remarkably better financial outcomes as a result.
#4 Improve provider efficiency
Paying a middleman to make calls to accounts without any segmentation is a buckshot method of debt collection. VisitPay will engage the consumer digitally, allowing the health system to manage patient obligations in alternative ways to early out programs and collection agencies. VisitPay enables providers to make better decisions regarding which accounts to send to early out providers, saving contingency fees on accounts that are already highly likely to pay. An added benefit of insourcing through the VisitPay platform is the continuation of direct contact and engagement between the patient, who’s a member of the community, and the health provider or system, who is both a stakeholder and a member of the community.
#5 One comprehensive view of the bill
At many health systems, patients are sent a new statement every time they have a visit and engage a new service. For a health system with multiple billing systems or systems that are migrating from one system to another, it’s a significant technical, operational and design effort to consolidate bills. With VisitPay, physician and hospital bills are organized in an integrated view for patients, who receive a single consolidated statement once a month. Some hospitals and health systems use Epic Single Business Office, pulling the physician and the hospital bill into one picture. However, even then, the consumer may receive multiple statements a month depending on the number of visits and whether a single guarantor has multiple accounts. For consumers used to receiving a single statement each month that combines multiple transactions (on, say, a credit card bill) this experience can be disconcerting.
Although most consumers want to pay what they owe for the care they need, today’s healthcare billing systems make patient payments painful. According to Forbes, patient payments account for 35% of some provider’s revenue. The explosion in high deductible plans means patients face balances of $2,000 to $5,000 much more frequently than in the past.
Aside from a lack of ability to pay and low payment rates, these trends and changes in benefits structure could be initiating many thousands of inbound calls a month to a health system. Patients need the ability to actively engage in the self-service of their financial responsibility.
Two mythbuster recommendations for CFOs
In addition to complementing your EMR with a consumer-focused platform like VisitPay, we also see two areas where our most successful health systems are focused:
#1 Make patient satisfaction and loyalty a priority
As comments from patient billing experiences become a key metric for the revenue cycle, as well as an indicator of whether finance leadership is supporting the strategic goals of the health system, improving patient engagement in the billing cycle is no longer an option. It’s essential to driving brand loyalty and maintaining high customer satisfaction levels.
How consumer-oriented are your patient billing services today? If patient loyalty translates into ongoing revenue for a hospital, shouldn’t building loyalty be a primary goal of the CFO? Given the rise in high deductibles and expanding number of patient payment accounts, long-term, low-interest payment options can no longer be the exception rather than the rule in healthcare.
#2 Reconsider credit and collection policies
Offering flexible and easy to understand payment options makes patients feel the health system is on their side, helping meet their financial obligations within a workable time frame. Giving patients more control over how to pay reduces anxiety and improves engagement, and patients who are more engaged in the process feel more confident in the overall quality of care received, end-to-end.
But behind the scenes CFO’s need to rethink their consumer credit and collection policies. Treating everyone the same, regardless of financial situation, is not a recipe for building a successful financial relationship with people most likely to need help managing a bill. VisitPay excels at helping systems tailor payment options and credit policies in ways that help find workable solutions for both the health system and the consumer. Leading health systems that integrate VisitPay’s flexible and automated patient revenue cycle management solution with the EMR are seeing increases in total patient dollars of 30% or more. Now, isn’t that a better outcome than having to pay external agencies to make outbound calls that no one wants to receive?