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Healthcare Reform

Healthcare Industry Shift: Patient Financial Understanding and Transparency

In the book Bless this Mess, author Stephen Klasko, MD asks why is it that Americans can easily complete all of their Christmas shopping online and price compare with a touch of a button on the day after Thanksgiving in the comfort of their homes, but to seek medical care it most often becomes an inconvenient and cumbersome ordeal? 

There is a large disparity between how the healthcare billing system operates and how all other consumer driven businesses are conducted— from Amazon to the banking industry.  We are on the precipice of a major tipping point. Are you positioned to stay relevant?

According to a 2018 survey conducted by West Health Institute, 40% of patients are more worried about how to pay their medical bills than about actually getting sick and receiving medical care. Two out of five patients skip medical tests and treatments because they are not able to afford it.

What good is high quality care if it’s not accessible and affordable?  Here are some things your organization should start now to drive patient financial understanding and transparency.

Align Clinical Care and Revenue Cycle

It should not be surprising just how much the patient financial experience affects the clinical experience these days. In previous decades, revenue cycle was mostly divorced from the clinical side, but in a recent Gallup poll, healthcare affordability is now the number one concern for those surveyed.

It ranks above crime, violence, hunger, and homelessness.

gallup poll

This is a critical issue for Americans worried about cash flow and high medical expenses—and it paints a dark picture for the future of healthcare.

Fortunately, it also presents an opportunity to create a great patient financial experience and turn around statistics like those above to change the tipping point.

Patients who are satisfied with their billing experience are twice as likely to pay their bills in full and five times more likely to recommend the health system to others.

Do you have enough staff and are your employees knowledgeable about patient billing?

If the answer is no, it may be as simple as increasing your staffing, offering additional training to your current staff, or partnering with an RCM firm to manage patient pay early out. If patients aren’t able to contact your billing office, or don’t have the opportunity to ask questions and receive answers about their bills, the likelihood that they will pay in a timely manner diminishes greatly.

Take Steps to Invest in a Creating a Positive Financial Experience

Hospital leaders should have a strong idea of what makes a great service experience and what makes a poor one. This is true across industries, and they no doubt experience this every day in their personal lives. People want the ease of use, knowledgeable representatives, convenience, high quality, safe transactions, and reasonable cost/payment expectations.

According to a new report by Kaufman Hall, which surveyed over 200 American hospitals and health systems, providers are homing in on patient-focused initiatives. It is nice to see the intent is there, but the report also showed that pricing strategy and price transparency still have a lot of room for improvement. For instance, less than half of organizations respond to patient requests for price quotes upfront, and only 10% have their prices listed online.

Are you leveraging patient pay technologies like secure patient payment portals?

If your website is clunky and requires too much patient information to access, it causes frustration for your patients. Offering payment plan options through the portal and secure autopay and recurring payment functions increases the likelihood of payment.

With the current technology available it’s possible to provide security, quality, and convenience along with best practices to improve the billing experience for your patients. Specialized software and technology in your patient pay department, at all points in the revenue cycle including your EHR functionality, is key to achieving necessary objectives in driving toward the financial experience.


Are your billing statements patient-friendly?

Patient-friendly statements, which explain what the balance is and why it’s owed, are an important part of creating a better billing process. In the Kaufmann report, only 28% of responding organizations send patient-friendly billing statements now, and even fewer organizations are working on their statement communications at all.

Consider a new design with easy-to-read and understand information, or perhaps a combined single statement incorporating both Hospital and Physician billing to improve the convenience and increase patient understanding. With the current technology available it’s very possible to provide security, quality, and convenience along with best practices to improve the billing experience for your patients. 

How transparent is pricing within your organization?

If you’re not providing payment estimates for patients at each point in the revenue cycle you’re not setting the expectations for payment early enough. From the very first point of contact, your patients need to know how much care is going to cost. Another factor in price transparency is to explain long-term and short-term payment plan options, assess for financial assistance from the outset, and also offer prompt-pay discount incentives. The more payment options the patients can choose from the more likely that they will pay.

Why Are Healthcare Providers Slow to Adapt to Patient-Focused Billing?

The answer—because they’ve never had to worry about it in the past. Now is the time to make changes that will put you ahead of the game,  or more realistically, get you in the game.

The Bottom Line

Health systems shouldn’t look at consumerism as a challenge, but as an opportunity to protect and promote their patients best interest and well-being—and not only on the clinical side. When it is clear that healthcare affordability is the number one worry for Americans today, your organization should strive to assuage financial concerns from the outset.

As you meet your patients' expectations for quality, affordability, and technological payment options that provide answers to questions along with convenience, soon you will reap the benefits. It comes down to providing great care and financial experience to increase the likelihood of patient payments.

After all, you only get what they pay for. And that is the real bottom line.


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