By David Shelton
Americans living in rural communities face many healthcare disparities. Unique factors such as geographic isolation, economic limitations, and shrinking resources only intensify the rural healthcare barriers that lead to a lack of access to care. The COVID-19 pandemic has exacerbated these disparities resulting in a negative financial impact on rural and community hospitals, a quarter of which were at high risk of closing before the pandemic.
Although improving revenue cycle efficiency is vital for any hospital, it’s especially so for healthcare providers who serve in areas of low population density. The U.S. Department of Health and Human Services (HHS) has recognized the critical situation and announced that $1 billion in additional relief payments will go to rural hospitals and other organizations serving vulnerable populations. However, this relief isn’t enough to keep these institutions solvent, so rural and community hospitals will have to implement additional strategies to bridge the financial gap.
In these unprecedented times, the approach rural healthcare providers choose to combat the financial crisis will have a long-lasting impact on both their business and communities served. To endure, rural hospitals must change the way they manage the business side of healthcare by integrating tech-infused solutions into every step of the patient’s financial experience. Rural and community hospitals need to restructure existing practices and processes to optimize technology tools for productivity and profitability.
Patient Access technology solutions will help to combat the unique challenges rural and community hospitals encounter when managing their revenue cycle, especially in today’s pandemic climate. Technology enables rural and community hospitals to promote accurate data capture to prevent errors that result in costly claims denials and low patient satisfaction. Through technology, rural and community hospitals can tailor workflows to address specific facility challenges as well as the individual needs of their patients. Customization is key to effectively addressing rural health challenges of shrinking reimbursements and staffing shortages.
Engage Patient Access Technology at Pre-Access
Effective Patient Access technology solutions fuse traditionally siloed registration, insurance verification, bill estimation, and payment planning together in a seamless workflow. Implemented at the pre-access stage of care, these solutions can address payment barriers and lack of patient financial awareness by empowering staff to treat patients as unique individuals, provide financial obligation education, and identify payment plans that meet each patient’s specific needs. The hospital should not have to wait for the statement to drop before engaging with the patient.
Technology not only helps rural and community hospitals streamline insurance verification, but also enhances the entire patient financial experience starting at the point of registration. Building a financial relationship with the rural patient before care is rendered is essential, especially because rural patients tend to have less internet access and cellphone connectivity, making it more difficult for them to find and understand insurance and the benefits for which they may qualify.
Pre-access patient engagement is instrumental in providing a positive first impression on patients. Registration staff should contact patients before appointments to verify insurance eligibility, deductibles, and copayments, and provide bill estimates so patients fully understand their financial obligations before they receive care. After all, a positive patient experience that starts at the first point of contact can set the tone for the entire patient care journey.
By engaging patients upfront, rural and community hospitals can educate patients about their financial obligations, alleviate fear and frustration, and deliver a higher quality patient experience with increased patient satisfaction. Technology can provide the groundwork for more frictionless patient experience by simplifying registration to capture accurate patient information at pre-access to increase collections.
Personalization through Technology
Similar to the clinical side of patient care, each rural patient’s financial situation should be addressed on a case-by-case basis. As with a clinical diagnosis, financial circumstances can vary greatly from patient to patient. Some patients can pay their bills at the point of service (POS), others require an extended payment timeframe, and yet some may never be able to meet their financial obligations.
In rural communities, registration and business office staff are often neighbors, friends, or even relatives of patients – making it uncomfortable to discuss the cost of care and how payments will be collected. Often, hospital staff tries to counteract the discomfort by having the same conversation with every patient regardless of their financial situation, which understandably can lead to patient unease and low point-of-service (POS) collections. But with Patient Access technology in place, the complex patient registration process can be woven into personalized, guided workflows that direct patient conversations to counsel patients on their financial options and establish positive relationships with no financial surprises to the patient.
Technology should guide staff to personalize the conversation based on each patient’s care needs, financial circumstances, and level of understanding. With the right technology in place, staff productivity and satisfaction increase, and clear patient communication occurs preventing surprises and difficulty collecting down the road.
Patient Financial Assessment
To be effective, Patient Access technology must be capable of evaluating each patient’s unique financial circumstances. The technology must determine the likelihood and ability to pay for each patient and guide staff-patient conversation to identify or customize an appropriate payment plan. Rural and community hospitals must evaluate factors to identify different payer group segments including:
- Credit standing
- Payment history
- Residual income
With appropriate segmentation, staff can recommend a payment plan that fits each patient’s circumstances which increases the likelihood of collecting the full financial obligation. As a whole, rural patients are like other patients: they want to pay their medical bills, but to do so they need an arrangement that fits their individual circumstances.
Patient Access technology that is implemented at pre-access and incorporates a data-driven, personalized approach will place rural and community hospitals on the road to financial recovery. There’s no doubt that the patient financial experience is important to all health care providers, regardless of size. However, it’s even more important for rural and community hospitals to know their patients and offer financial flexibility to meet their unique needs and improve reimbursements.
David Shelton is CEO of PatientMatters.