Preparing Patients for Surgery—Financially—As Procedures Resume During COVID-19

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By Mark Spinner, CEO and president of AccessOne

Listening to music before surgery can ease the body’s physical stress response, a recent study shows, but very little can prepare a patient for an unexpected medical expense. That’s especially true during the COVID-19 pandemic, when rising unemployment and fears related to loss of income and insurance abound.

Prior to COVID-19, one in five patients who underwent surgery they scheduled in advance received a surprise medical bill, typically from an out-of-network surgical assistant or imaging specialist, according to a JAMA study. On average, these bills added $2,011 to a patient’s out-of-pocket costs for surgery. 

But as hospitals resume elective surgeries that were initially postponed due to the pandemic, healthcare organizations likely will find that a no-surprises approach to medical expenses not only supports a positive patient financial experience, but also helps encourage patients to pursue medical necessary procedures.

A recent AccessOne survey found:

  • 58% of consumers say they would consider delaying a non-emergency but medically necessary surgery this year due to cost.
  • High-income earners are more likely to delay surgeries and diagnostic procedures than those with lower incomes, at 63%. Of these consumers, 46% would delay necessary surgery by up to six months.

The survey also points to the need to engage patients in cost-of-care discussions prior to surgery. When it comes to consumer payment priorities, medical expenses rank last during the pandemic, the survey shows. As a result, hospitals that don’t establish a plan for medical bill payment before surgery could face greater difficulty collecting the amount due after a patient is discharged. 

Given the financial pressures consumers face following COVID-19, what can healthcare providers do to help patients navigate the costs of a medically necessary procedure? Here are four approaches to consider.

Heighten transparency prior to any procedure.

Contact patients before surgery to provide an estimate of their out-of-pocket costs after insurance and ensure that patients know what the estimate covers. Explain the types of scenarios that could add to the patient’s expense, such as an unexpected complication. When patients are concerned that an anesthesiologist or surgical assistant tapped for the procedure could be out-of-network, suggest ways patients could avoid this scenario, such as by discussing their concerns with their physician or with the operating room team prior to surgery.

Engage patients in financial discussions early.

Consumers who don’t feel prepared to manage the costs of their care are more likely to postpone treatment. Yet a consumer survey shows that 31% of consumers feel only somewhat comfortable initiating financial conversations with providers, and 11% are uncomfortable doing so. Engage patients in conversations around how they will pay for the care they will receive at the point of scheduling, and explore how patients will manage their out-of-pocket costs. Screen patients for charity care or other financial assistance and assess whether a payment plan is needed.

Assist patients in managing their costs of care.

To give consumers greater confidence in undergoing surgery in during the pandemic, it’s important that providers not only make consumers feel safe entering a hospital, but also financially comfortable in pursuing care. For hospitals, this means offering a variety of options for payment, such as payment plans, as well as flexibility around payment terms, such as no-interest and low-interest plans. Payment flexibility is highly valued across generations: 69% of millennials and Gen Xers desire low-interest or no-interest payment plans to fulfill their financial responsibility for care, a recent survey shows. Meanwhile, 61% of Gen Xers and 39% of baby boomers desire the ability to change the terms of payment plans (for example, from no-interest to low-interest) when circumstances change.

Create a seamless patient financial experience.

Where possible, give patients a single point of contact during the payment process to provide continuity in financial care. Provide scripted language for staff to use during patient financial conversations, and train staff regularly to handle complex financial discussions—especially vital when 68% of consumers fear they will be unable to pay their medical expenses this year. Also critical: Establish common procedures for providing price estimates and sharing details around payment plan and enrollment, and offer self-service options for account management, such as through a patient portal.

Easing the Financial Stress of Care

Navigating the expense of a surgery is never easy, but the financial uncertainties surrounding COVID-19 intensify cost pressures for consumers of all income levels. That’s why it is essential that hospitals proactively pave the way for a more positive patient financial experience as consumers return to hospitals for care. Make it easy for patients to obtain out-of-pocket cost information before the surgery takes place, and help them explore affordable options for payment, with the flexibility to adjust payment terms, if needed. Doing so empowers patients during a time of economic turmoil and strengthens satisfaction and loyalty.

Mark Spinner is CEO and president of AccessOne, a leading provider of flexible, co-branded patient financing solutions that help patients afford medical expenses for health systems nationwide.

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