High-deductible health insurance plans and increasing numbers of uninsured individuals have driven the hospital patient self-pay population to a larger percentage of overall hospital charges than ever before. Growing patient/guarantor receivables is challenging healthcare administrators to find new and more creative solutions to meet operational and financial performance objectives. At the same time, healthcare providers are wrestling for market share, competing to retain patient, and seeking to differentiate by providing a superior consumer experience.
Managing the patient collection process while also giving the patient a great overall experience can be very challenging. Patients are rightfully expecting the same consumer experience from their healthcare provider that they receive from other consumer purchases. Meeting these consumer-driven expectations for healthcare services is not as easy or obvious as it might seem. As patients, they often:
- Have no idea what their expected financial responsibility will be even after all care has been delivered.
- Receive a confusing mix of bills and EOBs from multiple entities that are complex and can be difficult to understand.
- Are surprised by additional bills after believing their balance has been paid.
- Don’t understand the caregiver’s collection policies and perceive they are being unreasonably treated by the collections team.
The result of this confusion is not just unhappy patients but also delayed payments on outstanding patient balances. A longer-term impact is when patients become skeptical of their hospital statements and routinely drag out the payment process.
Addressing these outstanding patient balances is not a new challenge for providers – the need to improve point of service collections has been a growing issue for many years. But when the goal of improving the patient financial experience is factored in, it’s an area that needs a new approach. Many business offices and registration teams lack workflow integrated tools and timely information for effective communication with patients at the time of service. As well, registration staff sometimes have limited experience in influencing patient collections and do not have insight into the patient’s current financial situation.
The good news is that forward-thinking provider organizations are working to change all of this and deliver a positive financial experience. Best practices in this area focus on these key points:
- Integrating currently siloed business functions, including registration, billing, collections, and financial support so staff can speak to patients with a direct message that’s tailored for each individual.
- Coaching staff to engage with patients in this integrated way and to treat them compassionately as valued customers.
- Providing accurate bill estimates prior to care along with a customized payment plan so that patients know what to expect to pay, and when.
- Referencing propensity-to-pay data and analytics so hospitals can better predict the right mix of services, payment options and financial support.
- Expanding payment options to include individually driven payment plans, payment portals and direct lending to patients.
This new technology and workflow strategy is more effective, creating personalized financial solutions for every patient. This solution ensures the patients know what to anticipate from a financial perspective, have a realistic plan to meet their obligations, and can trust the provider organization to be fair and helpful. Organizations that have embraced these principals are seeing significant and measurable rewards, including collections, and improved HCAHPS and net promoter scores. They also see better cash flow performance, and can better predict patient collections.
Most importantly, these organizations are treating patients with the same positive care and compassion financially as they are receiving from their clinical experience.
David Shelton is President and CEO at PatientMatters.
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