All posts by Kerry Rivera
When it comes to paying for healthcare, “compassionate” is probably not the first word that comes to mind for patients. As they foot a greater portion of medical expenses, it’s often an experience rife with stress and uncertainty. Providers try to give accurate price estimates, but when patients switch coverage plans or payers change their policies, it’s difficult to be sure the original estimate matches the final bill. And what if a patient simply can’t afford to pay? When 56% of consumers say they would not be able to pay an unexpected bill over $1000, this not only indicates a tough ride for patients, but points to why so many providers are struggling to collect in full – around two-thirds of patient balances over $200 go uncollected. It’s unsurprising, then, that more healthcare organizations are looking at ways to create a better financial experience for patients. Understanding the collections process from the patient’s perspective and moving away from a “one size fits all” approach may be the key to a healthier revenue cycle. Could a more compassionate approach to billing help patients meet their financial obligations? How providers are turning to compassionate billing to help patients and improve revenue Thanks to advances in data analytics and technology, providers have a host of tools at their disposal to improve the patient financial experience. The following three strategies are generating some great results for providers: 1. Use data to give patients the right payment options A common pitfall across healthcare billing is to treat every patient the same. But sending a bill and hoping it gets paid is clearly not a reliable collections strategy. A compassionate billing approach means you look at each patient’s current financial situation and consider their ability and likelihood to pay. With the rich data analytics now available, you’ll know whether a simple statement will be enough to prompt payment from the patient, or whether a little extra handholding will be needed. Are there other payment plans that might be more appropriate? Would they benefit from a call or text to remind them of the next task they need to complete? Data analytics let you tailor the process so you can help your patients pay their bills in the way that suits them best, including finding missing coverage. Martin Health System used data-driven software to identify patients entitled to charity support, scrub for Medicaid eligibility and review agency performance. By segmenting patients more effectively and making sure the right agencies were working the right accounts, they were able to increase collections by $3.1 million and identify an additional $975,000 in Medicaid coverage over a seven-month period. 2. Personalize the way you communicate with patients Data analytics don’t just help you offer payment plans based on the individual, they allow you to determine a patient’s preferred method of communication. Do they prefer to get a statement in the mail or via email? Are there particular communication messages that will resonate with different patient groups? Paying bills can be a sensitive topic, especially if someone is struggling financially. Being able to create personalized messages at each touch point in the process is a helpful way to build compassion and consumer trust into the financial experience, so patients are more likely to engage with the process. The University of California San Diego transformed their patient financial experience by using Collections Optimization Manager to segment patients, as part of a broader exercise to improve collections. Knowing more about individual patients’ circumstances meant they could offer more relevant communications and build a more sensitive patient engagement strategy. 3. Make it convenient and easy to pay Every patient will thank you for a quick and painless payment process. Offering flexible payment options including online, in person and phone is critical. According to Kyle Wilcox of Grinnell Regional Medical Center, this is all about the ‘golden rule’ of patient payments: treating patients as you would want to be treated. He says: “At GRMC, we provide consumers with a range of choices to make payments, such as in person, by mail, electronically online or via mobile technology, and by cash, credit or debit card. Doing so allows them to pay in a way that is most convenient for them, improving their satisfaction and the hospital’s likelihood of receiving payment.” What’s more, efficient payment tools can improve your staff workflows too, giving them more time to help patients who need extra assistance and reducing the cost to collect. Heather Grover, Vice President of Product Management for Patient Collections, Experian Health, said: “We had a small community-based hospital use Collections Optimization Manager product with PatientDial. On average, the cost to collect for many of our clients is anywhere between 7% and 15%. They saw theirs decline to 5% and over a two-year period, their cash collections increased to 42% prior.” Ultimately, there are some patients who can pay and some who can’t. It’s a sensitive topic to navigate, but when patients feel supported, they’re more likely to be able to meet their financial obligations. Collections Optimization Manager lets you figure out who’s who and offer them the most appropriate support to get their healthcare bills paid, so they can get on with life.
It’s amazing to look back at how far medical science and digital technology have come – and how those two worlds are increasingly intertwined. Ten years ago, the idea of managing your healthcare bills or making appointments through an app on your phone would have been unthinkable. Now we take it for granted! But having all these tools at our fingertips means there’s more data being shared between different services and platforms. As a healthcare provider, you might be accessing and sharing patient data multiple hospitals, primary care services, pharmacies, patient portal providers, payers and more. It’s vital to make sure that data is accurate. Research by RAND Corporation revealed that between 8-16% of patient records are duplicates. Trying to provide care on the basis of unreliable data is inefficient and expensive for providers, who lose staff time and revenue trying to match up records and reconcile the data on file with the patient in front of them. According to RAND, a mid-size health system absorbs as much as $96 for each duplicate. What this means for patients is even more worrying. According to the US National Institutes of Health, “195,000 deaths occur each year because of medical errors, with 10 of 17 being the results of identity errors or wrong patient errors.” In a value-based system where patients are covering more of the costs themselves, the financial impact of having unnecessary repeat tests or longer-in-patient stays due to delayed treatment is an added pain. Currently, standard health IT products have some catching up to do, as only 10% of duplicates are spotted. But looking ahead, the future of patient identities is promising. Unique patient identifiers are key to unlocking value-based care The twin trends of value-based care and healthcare consumerism are bumping up patient expectations. They expect a seamless experience. They expect their records to be updated immediately. They’re confused when one department doesn’t have access to information that was just shared with another. And they definitely don’t want to see different services working off different versions of the same record. The answer for many high-performing health systems is to introduce unique patient identifiers (UPIs). This allows a patient’s record to follow them throughout their healthcare journey, ensuring that at every touchpoint, clinical and admin staff are confident in the accuracy of the information they hold. But transitioning to any new system can involve a bit of culture shock for those involved, and so careful planning is essential. What steps can providers take to make sure they implement a patient identity management strategy that’s built to last? How to future-proof your patient identity platform 1. Make sure everyone’s on board with the plan First, whatever solution you’re using to manage patient records, it’s essential that your patients, staff, payers and any other parties involved all buy in to the new approach. Changing the way you handle data and introducing new digital tools such as UPIs can often call for a mindset shift in the way your team and consumers think about data. Be sure to communicate the benefits of UPIs to patients, payers and staff. For example, UPIs can: improve patient safety, by preventing duplicate and inaccurate recordslower healthcare costs, by eliminating inefficiencies and errorssafeguard patient privacy, by keeping records securecreate a better patient experience, by supporting patient-centered carehelp staff access up to date information about their patient’s healthcare situation 2. Choose a UPI system that works within and outside your network Some providers use hospital- or practice-based patient identifiers, where a master patient index is used to link all versions of a patient’s record held within a single organization. An enterprise master patient index (EMPI) does the same, but across several facilities or services. A cross-enterprise solution makes it much easier to manage patient identities across your entire network, without having to wrangle disparate records that don’t interface well with each other. When this system is based on ‘referential matching’, which uses wider data sources and UPIs to build a more connected and accurate data ecosystem, you’ll get a much more complete view of your patients and far fewer inaccuracies. 3. Use data analytics to improve decision-making UPIs bring another advantage: they enable you to analyze health, credit and consumer data for a single patient, giving you useful insights about your patient population as a whole. A network of interoperable data can help you spot trends in the social and economic factors that affect health and wellbeing, so you can target your resources more effectively. As the world of public health data matures, it’s highly likely that UPIs will become the norm. Data-sharing remains a challenge, but by using digital tech to your advantage, you can improve the way patient records are managed in your health ecosystem. Learn more about how UPIs could help close the patient data gap in your organization.
At the end of 2019, Experian Health announced that every person in the U.S. population, an estimated 328 million Americans, had successfully been assigned a unique Universal Patient Identifier, powered by Experian Health Universal Identity Manager (UIM) and NCPDP Standards™ (the “UPI”). Universal Patient Identifiers (UPIs), created with a comprehensive view of patients from health, credit header, and consumer data sources, are thought to significantly reduce the challenges that stem from the misidentification of patients which span patient safety, financial, and operational inefficiencies. But what does 100% coverage mean? And what does this mean for the future of healthcare? To take a deeper dive, we sat down with Victoria Dames, an Experian Health leader in the identity management space to learn more. 1. It doesn’t get more perfect than 100%, so tell us more. What exactly does 100% coverage mean? Experian Health developed an algorithmic engine known as our Universal Identity Manager about five years ago. Since this time, we’ve worked closely with many providers, pharmacies and payers to help address their duplicate records. We’ve been monitoring our adoption and enumeration by unique patient identifiers against 328M individuals in the US population (2010 Census) and achieved this milestone at the end of 2019. Through our broad network of provider clients, which include hospitals, pharmacies, payers, and healthcare technology companies, patients who have received care from participating entities over the past few years have been enumerated. As new patients enter the healthcare ecosystem, this number will continue to grow. 2. Why are universal patient identifiers (UPIs) needed and how do they benefit providers and patients? The Universal Patient Identifier (UPI) helps providers link the right records together, preventing duplicate records from being created. For example, think of all the ways duplicate accounts or variances can occur: address differences, name variations (Katherine, Kathryn, Kathy, Kat), maiden names and potential user entry error. With the UPIs, providers can link records together and have one complete record and view of the patient, ultimately leading to a better patient experience. It’s important to note that the UPI is not something the patient knows or sees, but rather part of the technology. It can be embedded within a hospital’s information system, for example. It simply links a patient’s records together, so a provider has a complete view of the patient’s identity. The flow of communication happens when participating healthcare organizations send Experian Health patient demographic information; the system provides the organization in return with the insights and identifiers that they need to better manage patient identities and prevent duplicate records. The UPI can be attached - if the situational requirement is met - to active claims in real-time transactions effectively improving the integrity of patient records. During this process Experian Health does not rely on or use any clinical information about the patient; Experian Health only leverages the minimum data elements needed to successfully match an identity. 3. How did you get numbers assigned to all Americans? When a healthcare organization enlists our help, we process all their historical records through the UIM, returning a Universal Patient Identifier (UPI). The initial run of this data helps resolve existing duplicates which can date back several years. Working with multiple providers and pharmacies, we were able to get numbers assigned to all Americans. The number will continue to evolve of course, as the population changes with births and deaths. 4. Are there privacy risks with this? Experian Health is a HIPAA-compliant Business Associate when it receives PHI from customers. It takes its privacy obligations very seriously. As to UIM, privacy risks are minimized by the fact that the UIM does not leverage any medical records, prescription histories, or provider systems. The purpose of the solution is to assist healthcare professionals to better match an individual’s identity through data assets that would normally be unavailable to a healthcare provider. 5. Does a UPI function similar to a credit report, meaning it provides a singular view of a patient’s medical history? It depends on the situation. If a provider has a patient in their EHR twice under two spellings of the patient’s name in error, then yes, the UPI would link those two profiles, creating a singular view of the patient in that provider’s system. Additionally, the UPI generated by Experian Health is designed to help facilitate interoperability between healthcare providers. For example, if your pharmacy has you listed under your maiden name of Smith and your doctor has your married name of Wilson, during the ePrescribing process, your ePrescription might not get associated with your prescription profile. If both providers have the UPI on record and submit it during the transaction, the systems will match the patient using the UPI. It’s important to note that the UPI is technology for entities and is not patient facing. 6. What is the direct benefit to consumers; will it help them control their medical data? Consumers will benefit depending on how a provider implements and utilizes the UPI. For instance, if a provider has two medical records, and they merge this into one record, the patient will see one consolidated record. Imagine two patient profiles for the same individual at a pharmacy. One prescription is filled under each profile and the two separate prescriptions, if taken together, could lead to a severe reaction. If filled under two different profiles, the automated process to screen for drug interactions would not identify this harmful reaction. But the UPI directly solves for this issue. 7. What are the next steps and goals for Experian Health as it pertains to UIM? Our goal is to continue to partner with healthcare organizations to help prevent and resolve their duplicate records. We are continuing to invest in our technology and capabilities within identity, as we care deeply about patient safety and data integrity. Having a single, unified and accurate view of the patient is a challenge that plagues the healthcare system, and now we have a comprehensive solution that reduces the barriers to make healthcare safer.
The stats are alarming: Up to 80% of health outcomes are not due to medical factors, but to a patient’s social and economic circumstances—such as their income, housing situation and even whether they own a car.68% of Americans are affected by at least one social determinant of health (SDOH).Approximately 24% of hospitals and 16% of physician practices screen for food insecurity, housing instability, utility needs, transportation needs, and interpersonal violence—which means the majority don’t screen for all relevant social needs. The healthcare industry has been talking about the importance of addressing social determinants of health for years, but many struggle with how to collect the insights. For example, if 68% of Americans are affected by at least one SDOH, how do they even discover the one? What is the ideal way for providers to screen for SDOH? Should they simply ask the patient? Do they start a visit with a survey, probing for details that could ultimately impact care management decisions? Providers know these sensitive topics – housing instability, financial instability, food insecurity and onward – can be tough and uncomfortable conversations. So, where to begin? Should you rely on patient surveys to capture SDOH? Patient surveys can be a useful way to find out about many potential barriers to care. However, they bring limitations: Your insights will be limited to the patients who show up—so anyone who has struggled to attend an appointment (and therefore potentially with higher needs) will be left out It can be time-consuming and expensive to give staff the time and space to conduct personal interviewsThey rely on patients to be willing to share openly, but some may not feel comfortable doing soThere is room for error in how questions and answers are interpreted by both the survey team and respondentsSocial circumstances can change over time, so it’s possible that the information gleaned in the survey may not be relevant a few months down the line. Knowing SDOH can have such a huge impact on a patient’s health certainly means clinicians should discuss these topics in the exam room, but relying solely on patient surveys and conversations could lead to gaps in intel. When should you screen for SDOH? Screening for social needs when a patient first registers or engages with your services is a good starting point. But what happens when their situation changes between diagnosis and treatment? What if they disclose a social need to a specialist that wasn’t flagged on their initial intake form? Does your staff know how to discuss sensitive social issues? Can they create a safe space for patients to share? Have you got clear referral pathways when an issue is flagged? Look for possible touchpoints in the patient’s journey where referrals to support services would be appropriate. Looping in the relevant primary care services is a good way to make sure your patients are connected to community-based programs and supported throughout their journey, whenever a new or changed social need is identified. What types of data could offer the SDOH insights a provider needs? Geographical and community-level data can help a healthcare organization understand their patient population’s income, housing situation and employment status. These are useful for population-level care planning but aren’t patient-specific. A better way is to analyze securely collected consumer marketing data for more specific and accurate information. Working with a trusted data vendor that is a compiler of original-source consumer data can help you navigate your options. The real predictive power of SDOH data comes when you combine patient-specific information obtained through screening, with consumer databases. A third-party vendor can help you access data on your patient population’s income, occupations, length of residence and other social and economic circumstances. Your care managers can use this to inform proactive, preventative conversations with patients to solve any non-clinical gaps in care. Bottom line … When healthcare organizations have a holistic view of patients—and the SDOH that play a role in their lives—they can take steps to help prevent avoidable hospital visits, emergency department (ED) utilization, appointment no-shows and worsened conditions by encouraging and facilitating earlier interventions. The key is to start with the right data.
Did you know a whopping 90% of missed revenue opportunities can be linked to denied claims? At a time when providers are working to make up this lost revenue, they are also dealing with patients who are expected to cover more of their medical bills through out-of-pocket expenses. High-deductible health plans, free-care programs and crowdfunding are more prominent, leaving hospitals vulnerable to the patient’s ability to pay. Add in the rise of value-based care, and it’s no secret patients expect an experience that matches their interactions with other consumer services. They’re more engaged in their health and know they have options. Patient collections are down, but expectations are up. Loyalty wavers somewhere in the middle. How should providers respond? Legacy revenue systems aren’t set up for financial models based on value over volume, so providers need to adapt. It’s vital to find ways to help patients navigate the financial side of healthcare and make patient collection processes as efficient as possible. What does value-based care mean for your revenue cycle? Shifting to value-based reimbursements, patient-centric incentives and quality of care programs means your clinical and revenue cycle workflows need to be better connected. Patients must receive consistent and accurate communications throughout their healthcare journey, setting them up for the best possible health outcome and payment options. When the care and finance functions work together, your patient records can be kept up to date and the next admin task will be triggered at the right time. Here are some things your revenue cycle management (RCM) process might be missing: clear and convenient processes for patientsaccurate patient identification from registration to billingability to collaborate with payers to customize workflowsstreamlined workflows to reduce time and resources spent on avoidable tasksautomated processes to support effective collections and spot root causes of denialsreal-time reporting to help improve performance over time [Source: Frost and Sullivan] Data, analytics and automation can help you create more agile processes to minimize revenue leakage and create a better financial experience for patients. 3 ways to close the gaps in a value-based RCM model 1. Use consumer data to help patients make informed decisions A major cause of denied claims stems from patients being unsure about what their treatment will cost. Others are unclear about whether they have appropriate coverage. Help your patients weigh their financial options by providing accurate estimates and working with them to check coverage. Consumer data can support this process by giving you insights into your patient’s social identity, medical history, coverage status, insurance eligibility and propensity to pay. With an intuitive billing process, you’ll improve the patient payment experience and reduce revenue leakage. 2. Use analytics to predict gaps in your revenue cycle Many top-performing health systems use advanced data analytics to predict where the bottlenecks, errors and denials might creep in, so they can take swift action to address them and keep their patients and C-suite happy. For example, with analytics, you can get to know your patients better so you can segment them according to their financial responsibility and ability to pay. Not only does this mean you can focus your collections efforts more effectively, but you’ll have the right insights to help patients navigate the payment process with personalized nudges and relevant messaging. In addition, analytics have a huge role to play in eliminating avoidable denials resulting from unreliable or inaccurate patient data. You’ll be able to spot patterns in denials, so you can implement checks and processes to avoid them in future. 3. Put the right tools in place to close the gaps Close the widening gap between claims and collections starts by ensuring your patients are aware of their financial responsibility. A self-service patient portal could give your patients convenient access to their information in a time and place that suits them. They’ll be able to schedule appointments, enroll in payment plans, and apply for charity. They’ll see real-time, transparent and accurate information about price estimates and their eligibility and coverage. When the financial experience is transparent and frictionless, patients are more likely to feel satisfied and less likely to shop around for care – not to mention being better prepared to meet payment deadlines. And internally, data-driven automated software can help you monitor and manage every step of your revenue cycle. You can make life easier for clinicians and management teams with EHR-integrated dashboards, web-based financial reporting and timely alerts for the relevant teams. Schneck Medical Center used Experian Health’s Denials Workflow Manager to automate tedious manual processes, freeing up staff time and optimizing claims follow-up and collection: “No longer are we waiting 30 to 45 days to review denials. We can review them on the day of [submitting] if we choose to.” (McKenzie Smith, Director of Patient Financial Services) It’s simply no longer viable to use RCM processes that aren’t integrated across your entire digital ecosystem. Providers that can offer a convenient and personalized consumer experience, automate collections workflows and join the dots between clinical care and revenue management will have the competitive advantage in the era of value-based care. Learn more about how your organization can use data to predict and close gaps in your revenue cycle.
Did you ever have someone tell you, “there’s no magic pill” for reaching a goal? It’s a somewhat ironic analogy, given that so many people struggle to take their meds as prescribed. Following a medicine schedule actually takes a lot of organization and discipline, never mind the financial and emotional cost of having a daily reminder that you’re not well. It’s estimated that 50% of patients don’t take medications as prescribed. Sometimes a patient is busy and misses a dose. Maybe they forget whether they’ve taken it already and accidentally take double. Perhaps they feel better and decide to stop a course of meds early. Or maybe they can’t get to the pharmacist to get their refill on time. Unfortunately, medication non-adherence (MNA) can have a more direct impact on a patient’s condition than the specific treatment itself, according to the World Health Organization. Non-adherence is thought to contribute to nearly 125,000 deaths and 10% of hospitalizations each year. It costs the health care system between $100–$289 billion each year, and according to a study by Walgreens, for every 1% improvement in adherence, $50 can be saved in healthcare spending. The causes are varied. Of course, patients have a role. But healthcare organizations operating at various points along the care continuum can also play a big part in helping or hindering patients in sticking to their prescriptions. Doing so is in everyone’s interest, as tackling non-adherence can help reduce readmissions and avoid more serious medical conditions, improve patient loyalty, yield financial savings and create a better experience all around. Here are three ways different healthcare organizations can help patients stay on track with their meds: 1. Keeping accurate patient records from hospital to home When a patient is hospitalized, it’s fairly easy for them to stick to a medicine schedule. Drugs are dispensed in the same building and brought right to the patient’s bed at the appropriate time. The problems arise when the patient goes home. They may leave hospital with new prescriptions which can be confusing and if they already have a prescription, the admission itself can disrupt their usual routine. As things stand, hospitals tend not to be reimbursed for interventions to improve adherence, so these are less likely to be prioritized during care transitions. But given the likely improvements to patient outcomes and consumer loyalty, and the fact that hospitals could save $37 for every dollar spent tackling MNA, these interventions are worth a second look. A simple but effective place for hospitals to start is in improving patient identities. When your clinical teams know they have a 100% accurate and up-to-date record for each patient, including their current prescriptions, they can help the patient stay on track and prescribe new medicines with confidence. New identity management platforms such as Universal Identity Manager can help you keep track of patients and their meds, reducing the risk of medical errors and avoiding billing mistakes associated with duplicate prescriptions and preventable readmissions. This ‘golden thread’ of patient information can also improve communications within and between providers in your health system, such as Accountable Care Organizations (ACOs), pharmacies and other community providers. 2. Understanding and addressing wider barriers to adherence Common barriers to adherence often relate to a patient’s circumstances at home, such as not being able to get to the pharmacy because of a lack of transport, or because the opening hours don’t fit with their work schedule. For patients juggling work, childcare and other responsibilities, refilling their prescription can easily slip down the to-do list. Pharmacies can help by offering logistical support such as automatic refill programs, home delivery and help with organizing medication into pill boxes. But how do you know which intervention will be most relevant? This requires a wider understanding of the make-up of your patient population and their needs, preferences and behaviors. Understanding the social determinants of health can help you identify the specific barriers to care for your healthcare consumers, so you can put in place the right response. 3. Develop patient engagement strategies to help patients take their meds It’s not just those directly involved in providing care who can help improve MNA. Payers can help in two major ways: firstly, by supporting members to overcome barriers such as cost and confusion, and secondly, by working with hospitals and pharmacies to help them develop effective strategies to reduce non-adherence. For example, Blue Cross Blue Shield of Arizona (BCBSAZ) has introduced a text messaging service to send reminders to members about their prescriptions, with a $45-50 discount on copays for those that refill on time. It’s hoped this program will tackle behavioral barriers to adherence such as procrastination or forgetfulness, while also addressing price concerns. Chris Hogan, Chief Pharmacy Officer at BCBSAZ described the program “as being a very high tech, modern, simple and effective addition to our overall initiative to improve medication compliance.” This kind of personalized patient engagement can be very effective in helping patients to stay on track. With ConsumerView, you can access a wide range of high-quality demographic, psychographic and behavioral consumer data, to help you offer personalized support such as digital reminders to your patients. You can develop engagement strategies tailored to the specific needs of your patients in just a couple of clicks. Could one of these strategies help your organization do more to improve medication management? Learn more about how we can help you help your patients – and your bottom line.
There’s no doubt that identity theft is a concern for any industry that handles sensitive customer information; health care is no exception. In 2017 alone, the U.S. Department of Health and Human Services reported 477 healthcare breaches. Together, they compromised nearly 5.6 million patient records. Without adequate IT security, everything that organizations use to improve patient engagement and the continuum of care – especially patient portals – becomes an open door for hackers. But how do we keep patient data secure without burdening patients? We asked Victoria Dames, Experian’s senior director of identity management, how the healthcare industry is evolving to solve for identity theft, as well as best practices all healthcare organizations can adopt to better meet this growing threat. In the world of healthcare, both patients and providers are understandably hyper-sensitive about the exchange and security of healthcare data. How is the industry arming itself to protect data? Are there any shifts you’ve witnessed in security practices over the past few years? Absolutely! The industry has quickly evolved into leveraging technology to share data between organizations and with their patients, but this does bring inherit risk. Criminals also took notice to this shift, and medical identity theft became one of the fastest growing types of identity theft with a roughly 22 percent annual growth. With this evolution, the industry has tightened up on data access, especially as it pertains to the patient. Over the last five years, we’ve seen the shift to enable technology to help identity-proof patients before granting them access to sensitive information. This used to be a manual process. What are some of the best practices healthcare organizations can adopt to limit instances of medical identity theft? First, organizations must understand where their access points are throughout their ecosystems. With 64 percent of patients citing a privacy issue as a key concern for accessing health information online, they should inform patients that they’re providing secure methods for access to their information. Additionally, healthcare organizations must evaluate how physicians access different types of data and portals. As healthcare caught up to electronic records and systems, portals for e-prescribing also arrived. Given the nature of this use case, providing a heightened NIST level of identity proofing is required. The key is to assess what level of identity proofing is needed at each entry point to keep balance on security and the end-user experience. When you look to the future of healthcare, what types of digital technologies and solutions do you see providers putting in place to prevent fraud and protect patient data? Technology moves quickly and so do we. Identity proofing has seen an acceleration in the use of biometrics at different points of entry throughout healthcare organizations, which strengthens our solution. We are starting to see the use of biometrics, similar to your phone face ID, used more broadly through healthcare in conjunction with existing identity-proofing solutions. Experian achieved the Kantara Initiative certification with adherence to the latest guidelines achieving NIST 800-63-3 IAL2 (National Institute of Standards and Technology Special Publication Digital Identity Guidelines 800-63-3 for Identity Assurance Level 2 (IAL2)). This reinforces our commitment to support clients in authenticating consumers, while balancing a positive experience. Learn more about Experian’s identity management solutions.
Chalk it up to the rise of high-deductible plans or decreasing payer reimbursements, but the numbers don’t lie: patients are footing more of their healthcare bills and hospitals are struggling to collect. In fact, a recent TripleTree report revealed there has been a 69 percent increase in consumer payments due to providers over the past four years. That same report also noted providers collect only 1/3 of patient balances larger than $200, with the balance being sent to collections or written off as bad debt. All this to say … collections can make or break a hospital. So, how are hospitals compromising on their collections game? Let us count the ways: 1. They treat all patients the same. Some patients may be able to cover all their care costs up front, while others need to spread out payments, or perhaps get help from a lender or charity. Logical, right? But for some reason, many hospitals take a one-size-fits-all-approach to their collections work. They’ll simply submit the bill, wait for payment and see what happens. If payment fails to come in after repeated attempts, they send the account to collections, and the agency often takes a similar approach. Scoring and segmenting patient accounts based on who has the propensity to pay –and directing them to the in-house or outsourced team most likely to collect – is a much more productive collections strategy. Even better, providers should try to determine what patients owe before a procedure, and reveal payment plan options from the start. By developing a means to estimate the cost of a patient\'s care, providers can deliver a figure to target for pre-operative, pre-procedure collection. 2. They lack an agency strategy. Just as hospitals can take one-size-fits-all approach with their patient collections, so too can be the case with their collections agencies. Some hospitals find themselves struggling with how to reconcile accounts placed with their agencies. Others are unhappy with their early- or late-stage collections vendor, but can’t quite pinpoint where it’s all going wrong. Advocate Aurora Healthcare, an operation with 27 hospitals and 500 outpatient locations, was trying to oversee 20 different collections agencies just a few years ago. They wanted to reduce the number of agencies doing their collections work, and gain a clearer understanding of who was performing best, but they lacked the data insights to evaluate. By tapping into a collections optimization platform, Advocate Aurora was able to reduce their agencies from 20 to four, and they started seeing double-digit increases in their patient collections. Routing accounts to the optimal collections resources, and using collection agencies judiciously, minimized their collection costs, and helped them stay focused on patients who can and will pay. 3. They rely on limited data sources. To create a truly effective collections strategy that is both predictive and insightful, hospitals need to rely on data sources that offer breadth and depth. Let’s consider an example. In the credit world, financial services companies can be looking at two consumers with identical credit scores and come to the conclusion that they should treat each the same. But with more data insights, a lender might see that one is trending up, making on-time payments that exceed the minimum balance, and the other is trending down, showing signs of payment distress. With historical data and other insights, the financial lender would likely treat each of those individuals differently. Agree? The same scenario can unfold in the healthcare space. If providers are solely looking at zip code data, or historical healthcare data, they will be challenged to offer personalized payment plans and decisions around how best to collect. Combining various data sources, including credit data, can provide hospitals with deeper insights into a patient’s propensity to pay and financial disposition. This allows healthcare organizations to identify the best financial pathway for each patient at, or before, the time of service, and will ultimately optimize their account receivable performance as well. --- By flipping the switch on a few of these strategies, hospitals can turn their patient collections game around. They’ll see gains in patient satisfaction, improvement in the accounts receivable bucket and the power data can have on segmentation. There’s really no excuse to fail.
