Healthcare in the patient-as-payer era has reached an inflection point as health system margins grow tighter and patients become more frustrated with both rising bills and their provider’s inability to help them sustainably manage those obligations.
While there are dark clouds boiling on the horizon, the good news is that healthcare is brimming with innovators, problem-solvers and big dreamers—dedicated professionals born to tackle healthcare’s most intractable problems.
Many of these people have applied their talents and ingenuity to the complex challenges of patient medical billing. So we asked a few of them how they plan to tackle the patient financial experience in 2019.
While answers varied in the particulars, they all shared a broader theme: better financial outcomes lay in experience, not collections. Improved coding or process reforms may work wonders with health plan reimbursement, but do little to help patients manage and pay off a mortgage-sized medical bill.
“I think the goal of the health system is to not be singularly focused on revenue cycle collections but to think more broadly about the holistic experience of a given consumer or patient,” said Gena Bezdek, Senior Director of Client Engagement at AVIA. “So, if there is communication around preparing for a visit, how might we think about really leveraging the skills of the revenue cycle team with the skills of the clinical team?”
Billing Accuracy is Key
Health system billing is managed very differently than other financial obligations consumers face every day. It’s complicated and confusing, and the balances are often large and unexpected.
According to Julie Olson, Manager of Customer Service at St. Luke’s Health System, greater billing accuracy is foundational to a better patient financial experience. “It empowers the patient,” she said. “That helps us provide them with options to pay off that bill.”
In a digital world, it’s easy to forget that there is a complex person behind every bill. Health systems need to be able to draw from their own data to create a more holistic portrait of their patients. Health system executives must take an inside-out approach to understand consumers’ ability to pay, propensity to pay and behavioral characteristics.
“I definitely think there is a lot of data that doesn’t really get utilized from the standpoint of historical patient behaviors,” said Marysabel Keller, Patient Financial Services, Self Pay Manager, Inova Health System. “For example, a patient’s balance can change from what is ordered to what is actually dictated, documented and billed. There’s a gap between what patients thought a bill was going to be and what the reality is. How we close that gap is through data, analytics and partnerships—utilizing that knowledge to make changes with the patient in mind.”
Knowledge is Power
Online resources are also important to help patients become more familiarized with their medical bills. Access to the appropriate tools to make key financial choices is critical.
“We need to figure out better ways to communicate with our patients early on in their visit so that they’re more aware of what their balance may be,” said Lorrie Jost, Director for Cash and Customer Service for BJC Health Systems. “And we need to come at it in a comprehensive way: that we care about you as an individual.”
Jenny Renee, Director of PFS Patient Contact Center at Inova Health System, said, “I want to give patients the ability to choose how they’d like to ‘connect’ with Inova, by offering them multiple ways to pay that also takes into consideration their financial ability. I want our patients to know Inova cares by providing them with an experience that is compassionate, convenient and financially flexible.”
Todd Craghead, Vice President of Revenue Cycle at Intermountain Healthcare, also believes that access to patient-centered technology can make a difference.
“Intermountain will continue to work to streamline the intake process by leveraging new technology and/or functionality within existing technology. This will include ongoing efforts to expand users of VisitPay, with aspirations to advance together our efforts on the front-end,” he said. “Getting a line of sight into how we ‘financially clear’ patients pre-service or point-of-service using pre-service payment plans would be awesome.”
Several thought leaders noted that improving the patient financial experience is not a static endeavor. It’s constantly changing and needs to be measured and revised based on an array of evolving circumstances.
The clinical side of healthcare is anchored by numerous internal and external benchmarks for measuring patient outcomes, clinical efficiencies and adherence to value-based care initiatives. The financial side has none of these, yet that experience can color how patients judge the overall healthcare experience. In a more consumer-focused environment, health systems will need to judge the success of the financial journey it has created for patients.
“We’ve measured the patient financial experience for years, and we measure it in a variety of ways. Surveys, feedback from using Visit Pay and other platforms, and we continually ratchet that up in terms of patients who evaluate our experience as very good to excellent,” said Bob Mueller, Vice President of Revenue Cycle at St. Luke’s Health System.
What It All Means
The patient-as-payer era represents a significant risk to all hospitals and health systems. But it also offers opportunities to those who approach this challenge with empathy, transparency and the desire to help patients manage their bills for good.
Whether your focus in 2019 is technology, communication or benchmarks of success, the common denominator is tying the financial experience to the overall healthcare experience. Patients require an individualized approach that makes them feel heard and empowered.
Healthcare billing is rapidly transitioning from a primarily business-to-business transaction with payers, to one that includes a consumer element. These consumers have heightened expectations for their transactions thanks to their purchasing experiences in every other aspect of their lives.
“We help health systems adopt new payment strategies that prioritize experience over collections through transparent billing, consumer-friendly payment options and an emphasis on patient control,” said Kent Ivanoff, CEO of VisitPay. “Health systems can forge a comprehensive approach to medical billing that helps patients understand what they owe and provides the tools they need to make incremental and manageable payments. This not only improves a health system’s yield and cash flow but also positively impacts patient satisfaction.”