The following is a guest article by Nick Davis, The SSI Group
We wouldn’t expect to order a meal from a restaurant without knowing the price. So why do so many providers struggle to get these conversations right in healthcare?
A recent survey shows 91 percent of consumers believe healthcare prices should be as readily available as prices on a restaurant menu. Sixty percent want their physicians to discuss costs of care, and 96 percent believe hospitals should be upfront about costs of treatment.
When consumers can’t find the answers they need and fear they won’t be able to shoulder the expense, care decisions are impacted: 51 percent have delayed care because they lacked the ability to pay for it.
Patient financial engagement—the efforts providers make to discuss costs of care before care is delivered, collect the out-of-pocket portion due, and provide affordable payment options for those in need—is critical to the patient financial experience and to patient retention. But conversations around patients’ financial obligations often are complex, and navigating these discussions can be challenging.
How can healthcare revenue cycle teams create a consumer-friendly approach to patient financial engagement? Here are three strategies to consider.
Give staff the tools to accurately estimate out-of-pocket costs. The most meaningful approach to price transparency is to share the anticipated amount patients will pay for care or service after insurance covers its portion. Train patient access staff to use price estimation tools to provide out-of-pocket cost information during preregistration, one of the first encounters a patient will have with your organization. Make certain that staff initiate discussions around cost during preregistration and upon arrival for care or service and understand why these conversations lay the groundwork for a compassionate care experience.
One other option to consider: Invest in a patient-facing tool for price estimation. Such tools use intelligent logic to calculate charges, determine the contracted rate, and apply patient benefit information—such as the amount of the deductible met to date—to determine the patient’s estimated financial obligation at the earliest point of contact.
Engaging patients in their costs of care enables patients to plan for the expense or ask questions that could help lower their costs. It’s also an approach that helps ensure providers are compensated for care delivered: Studies show consumers are more likely to pay their healthcare bills when their costs of care are clear.
Use data to tailor patient financial communications to the patient’s needs. With out-of-pocket costs increasing across all care settings in 2018 and medical fundraisers accounting for one in three GoFundMe campaigns, leading health systems use data to assess:
- Patients’ ability to pay their healthcare bill and
- The likelihood that a patient will pay, given past payment behavior related to medical bills as well as consumer goods and
- Patients’ eligibility for financial assistance
With this information in hand, staff are better able to use targeted messaging that increases the odds of collection, explore payment options with patients who are willing to pay but may struggle to pay their balance upfront, and determine whether a patient may qualify for outside assistance. Revenue cycle teams also can leverage this data to focus attention on accounts where payment is most likely to be received, increasing efficiency while reducing the cost to collect.
Explore digital tools for patient financial engagement. Consumers desire more modern methods of patient financial engagement, a recent survey shows:
- Half of consumers are frustrated by providers’ lack of digital options for accessing payment information or paying their bills online—including two-thirds of patients ages 18 to 24 and 29 percent of seniors.
- 38 percent desire improved customer support for immediate billing questions.
- 33 percent of patients want digital payment options.
- 41 percent yearn for consolidated bills across providers.
When patients fail to get the digital experience right, the impact on patient satisfaction and retention is deep: 41 percent of consumers surveyed say they would stop going to a healthcare provider based on a poor digital experience, from online bill pay to mobile and email bill delivery. One in five have already made the switch.
One first step in building a better digital experience: Ask patients for their communication preferences—whether by phone, email, online portal, or text—and use this information in tailoring patient financial communications. Make sure to provide payment options via each channel, and craft messaging that encourages patients to pay their out-of-pocket costs up-front.
Adopting a Consumers-First Mentality
At a time when transparency is one of the top two areas of strategic focus for healthcare leaders in 2020, it’s clear that patient financial engagement is top of mind for C-suite leaders as well as revenue cycle leaders. Designing a patient financial engagement strategy with consumers’ needs and preferences top of mind is critical to creating an experience that is highly transparent, highly personalized, and more immediate. This type of strategy will prove crucial not just in strengthening the organization’s bottom line, but also in securing and maintaining patient loyalty and satisfaction.
About Nick Davis
Nick Davis is vice president, product management for patient access solutions for The SSI Group. Nick specializes in patient access software, including patient data validation, eligibility verification, electronic data interchange, and patient financial clearance.