To survive, providers must be compensated for care. Increasingly, a greater portion of that compensation comes directly from patients, but the collection-by-attrition strategies used by many health systems to recoup pennies on the dollar often comes at the cost of patients’ trust and your health system’s hard-earned reputation.
Patient billing, like other parts of the experience, remains wedded to process when it should be driven by the consumer’s expectations and needs. Finding the sweet spot between patient satisfaction and payment means that health systems must bring order and control to a process bedeviled by confusion and uncertainty.
A Practical Roadmap to Patient Engagement
A meaningful financial engagement strategy helps patients understand what they owe and provides the tools they need to make manageable payments. This not only improves patient satisfaction but also positively improves yield. Here are four building blocks to making this strategy actionable:
1. Understand the patient perspective. Patients are not payers in the traditional sense but have more skin in the game than ever before. The relationship between commercial or government payers and providers is built on rules and processes that, if followed, result in reimbursement. The patient-as-payer doesn’t operate within that framework nor do they understand it.
Medical bills are confusing and frustrating for most patients because bills are static snapshots of highly fluid processes creating more questions than answers. How much will services cost? Is everything in-network? What are the options to make low-interest payments over time? Who can help me? These questions are suffused with anxiety.
Putting patients in a position to successfully manage their healthcare obligations starts with understanding how patients approach medical bills. It’s the bedrock of any sustainable financial engagement strategy. Once the patient’s perspective is understood, tools designed to meet those needs can be applied.
Adopting modern, point-of-service tools is a baseline capability for any financial engagement strategy.
2. Deliver consumer-centered tools for clarity and control. What disconnects all the medical billing horror stories these days is erroneous and conflicting statements, EOBs that quickly pile up in the wake of a healthcare encounter and almost super-human levels of organization just to arrive at a confirmed amount owed.
Through self-service technology, consumers access a clean statement with consolidated charges alongside EOBs, discounts and the amount covered by insurance. Moreover, consumers have the option of unifying all family members under one account to manage any number of people—aging parents, adult children, grandparents, and other family members.
Adopting modern, point-of-service tools that provide patients with clarity on estimated patient liability and equip health system staff with resources to manage upfront payment requirements and tailored financing options, is a baseline capability for any financial engagement strategy.
Cutting-edge payment solutions offer health systems the ability to personalize offers to patients.
3. Make bills manageable. Patients understanding what they owe is just the start. The next piece of the puzzle is uncovering insights into the patient’s ability to pay and customizing flexible and longer-term financial solutions to help them do it.
Health systems typically offer patients some type of payment plan option, but practices vary widely across systems and provide only limited opportunities for better patient payment outcomes.
There is no one-size-fits-all approach when it comes to patient payment obligations. Cutting-edge payment solutions offer health systems the ability to personalize offers to patients. Health systems should be able to deliver differentiated financial offers to patients in an automated manner, and provide variations around discounts, minimum payment amounts, interest rates and interest-free periods. This approach simplifies the process for patients while enabling providers to set minimum installment amounts and maximum payback terms based on customized rules. It’s a friendlier model to high-dollar, high-risk transactions.
Building customized financial plans and prioritizing accounts for personalized outreach calls for health systems to segment patient populations based on factors that go well beyond propensity to pay. Segmentation uncovers insights into how different patients interact with the health system at different times, which can vary widely based on several factors, including disease burden, lifestyle and insurance type.
Data drawn from EHRs, billing platforms and other systems of record are structured to create a detailed segment of the consumers, as well as their interactions, obligations, behavioral tendencies and ability to manage financial responsibilities. This information is then used to inform the strategies for when, where and how to engage with consumers and build a meaningful experience.
A platform that incorporates the ability to test strategies and adjust as needed is essential to getting it right.
4. Test, measure and adjust. Patient financial engagement is an evolving process that requires continual reassessment and refinement. A platform that incorporates the ability to test strategies and adjust as needed is essential to getting it right.
Once the program is in place, it’s important to use the right type of data and reporting to measure results, including a feedback loop that allows healthcare organizations to continually optimize and improve financial and satisfaction outcomes. Failure to include this element in the patient financial interactions will result in a sub-optimal experience for both patient and provider.
The Art and Science of Patient Engagement
Health system CFOs are coming to understand that clinical and financial experiences are no longer exclusive; patients increasingly view them as a single experience. Interactions in one area impacts decisions in another.
For this reason, financial touchpoints must stretch across an entire healthcare journey and education and communication regarding financial options must be tailored to the specific needs and preferences of the patient.
As everyday consumers, patients are used to receiving information and program terms that are customized and relevant to their individual needs. They are also used to making decisions and moving forward with them instantly. It’s the experience they expect, which means healthcare organizations who offer this experience will gain a significant competitive advantage over those that cannot.
Most of the essential elements that comprise the ideal consumer financial experience—collaboration, education, consistency, engagement across multiple touchpoints—have informed successful clinical practice for years. Healthcare organizations that want to deliver at this level will need to invest in a platform that enables them to tailor data-driven offers bring clarity and confidence to the financial side of healthcare.