First Pst after migration to Cloud in Health care Blog

Two years after the No Surprises Act was signed into law, healthcare price transparency and billing remain trending topics in the healthcare world. Together with the CMS final rule on price transparency, new regulations aimed at helping consumers better understand and plan for healthcare expenses have the potential to reshape the patient experience. Patients, providers, and politicians share an interest in improving price transparency. But developing and implementing the necessary processes has proven to be a challenge for providers. Meanwhile, the regulatory landscape continues to evolve, creating new challenges and expectations across the board. Where does price transparency stand today? Experian Health caught up with Riley Matthews, Senior Product Manager at Experian Health, to talk about the future of patient estimates and healthcare price transparency. Q1: As regulations have taken effect, how are patient perceptions changing when it comes to price transparency? “Patients are definitely here for these mandates,” Matthews says. “Most consumers have had the challenge of going to a hospital for care and finding out the bill is not what they expected. Maybe they didn’t even know what services they were getting in advance, or what the price for those services would be.” Now that price estimates and online pricing information are increasingly available, the consumer mindset is changing. Armed with greater access to information, patients feel empowered: “It’s changing the marketplace,” says Matthews. “Until now, healthcare hasn't truly been a free market: Pricing information has been kept very close to the chest and, often, patients didn’t see pricing until services were about to be rendered. At that point, they didn’t have time to evaluate. Patients can now see what the price of a radiology visit is at different facilities and compare.” As price transparency gains traction, consumers can be more proactive about the cost of care and managing their financial responsibility. Q2: What are the incentives for providers to comply with regulations and provide greater price transparency? “If someone is buying a car, they can search multiple dealerships online and compare pricing. Now, because of these mandates, patients can do the same for knee surgery,” Matthews explains. “If providers and hospitals aren't complying—if they’re not giving patients tools to help them understand and meet their financial obligations—they’re taking a risk.” In a study from Experian and PYMNTS, six in 10 patients who paid out-of-pocket for healthcare costs and received either an inaccurate estimate or a surprise bill said they would switch providers for a better payment experience. Separately, the regulatory consequences for failing to meet mandated requirements could escalate if the industry fails to comply. “CMS is likely to do more audits to enforce these mandates,” says Matthews. “The mandates themselves aren’t necessarily changing, but the amount of financial impact to providers and hospitals who don't comply is increasing. Price transparency violation fines start at $300 per day for a breach in the mandate, but they can go up to $5,500 a day or just over $2 million per year.” Q3: Have regulations been effective at motivating providers to get up to speed on implementation? “Implementation is accelerating but it hasn’t been quick,” Matthews says. “Compliance is on everybody's list of priorities but bringing systems up to speed has been a challenge: Technology takes time. Experian Health offers two solutions to help providers meet the core mandate for the CMS final rule. The first is Patient Estimates, a self-service portal patients can use to generate price estimates, make payments, and more. “Our self-service payment estimates portal provides a searchable list of prices for 300 common services, so patients can go to their hospital’s website and get a quote or view pricing,” Matthews says. “We’ve checked the box on that part of the CMS rule.” To meet the second part of the CMS mandate, Experian Health is partnering with Cleverley + Associates to create a downloadable, machine-readable pricing file for providers that can be digested and used across the organization. “Because there’s no standardization, providers haven’t been sure how to build this file,” Matthews says. “Many don’t have the tools or capability to do it themselves. “Combined with our self-service patient estimates, our partnership with Cleverley means Experian now has a full end-to-end solution that can solve for price transparency,” says Matthews. “And now that clients have a solution they can purchase and use, we expect to see an acceleration in adoption and compliance.” Q4: How are price transparency regulations evolving? What’s ahead for 2023? Both the CMS price transparency rules and the No Surprises Act are already having an impact on patients, who can now expect to receive a cost estimate prior to treatment. New online tools are on the way to help them understand their upfront costs. “Both of these regulations are meant to ensure that—there’s no better way to describe it—there are no surprises when a patient gets their bill, especially in self-pay scenarios,” says Matthews. “We already see providers moving in this direction.” But there are changes ahead. “The No Surprises Act isn’t fully fleshed out,” Matthews says. “Additional rules are going into effect January 1, 2023, and the industry is waiting on future regulations for insured patients that haven’t even been seen yet. Existing regulations will continue to evolve.” States are enacting additional mandates as well. According to Matthews, New York, Florida, and Colorado have all started to refine or expand their state regulations. Mandates in Colorado, for example, will allow patients to get price comparisons or dispute charges in advance of service. Q5: What actions should providers be thinking about as we move into 2023? Providers need to find the strategy that best fits their organization: “If a provider lacks a solution for both parts of the CMS mandate, they may want to reach out to a partner who can help support both, like Experian Health and Cleverley,” Matthews advises. “And if providers already meet half the mandate—if they currently have a portal like ours where those services are listed but lack the machine-readable file—they can identify whether it makes sense to partner to meet that other half. Providers can consider their costs and risks in each area and identify what works best.” At the same time, providers and their partners need to keep the patient experience top of mind. Although patients welcome greater price transparency, offering up-front cost estimates and pricing tools are only half the equation. Patients may also need financial help in the form of easy online and mobile payment options, payment plans, or charity assistance. “Philosophically and culturally, patients have been conditioned to approach healthcare without focusing on price,” Matthews says. “If they need specialized care, their doctor refers them to a specialist and they go. They don't see who's in or out of network or research what the prices will be. This has been the accepted process for many patients, including me. But perceptions are changing, especially as high-deductible health plans have become common now. Patients are becoming a little bit more skeptical.” Price transparency has the potential to make patients better consumers by empowering them to take charge of their own healthcare and their financial well-being. “Regulations are giving providers greater responsibility for price transparency, but a change in the consumer mindset is creating an equally compelling need for improvement,” says Matthews. “The game is definitely changing.” Discover how Experian Health can help healthcare organizations comply with healthcare price transparency and create better patient experiences.

Hospitals continue to face a capacity crisis as COVID-19, flu and respiratory syncytial virus (RSV) converge. Staffing shortages in both clinical and administrative teams further constrain the delivery of optimal care, with consequences for patient satisfaction and provider cash flow. With this challenge still ongoing, providers must find ways to maximize operational efficiencies and maintain patient flow. Accelerating patient intake with automated patient registration is a good place to start. Too often, registration requires patients to spend hours in a waiting room, filling out forms on a clipboard and conjuring up insurance information and medical history details from memory. These clunky processes cause delays, errors and stress for both patients and staff. In the current climate, healthcare providers should leverage digital tools that allow patients to complete registration easily and efficiently before they come in. Pitfalls of paper-based patient intake During registration, patient access teams must put considerable effort into collecting and checking patient information, documenting medical history and medications, verifying insurance eligibility and making sure the patient knows the details of their appointment or referral. Often, these checks are completed manually, with patients filling out paperwork in person when they arrive. It’s a slow and tedious process for patients and staff, made worse when there aren’t enough staff available. Unfortunately, manual processes also open the door to errors, creating additional work for staff members. If a patient’s address is inputted incorrectly, they may not receive important communications about appointments or billing, causing delays and confusion further down the line. In The Digital Healthcare Gap, a report by Experian Health and PYMNTS, Experian Health President Tom Cox says the “waiting room experience” is a common pain point for patients: “Having to schedule appointments at exactly 8 a.m. when the office opens isn’t convenient or efficient. Filling out paperwork that one has completed several times as a prerequisite to seeing a care provider aggravates just about everyone. And finding out how much the doctor visit and treatment costs long after the visit is complete is an experience unique to healthcare.” It's not an ideal first impression for patients, and it only compounds the pressure on short-staffed teams. Accelerate patient intake with advanced registration In The Digital Healthcare Gap, one-third of patients surveyed said they filled out registration forms from home. Enabling patients to complete registration in advance can greatly speed up patient intake. Patients can fill out forms in their own homes, with all their medical details at hand. It’s a more comfortable experience for patients and saves staff time by reducing the risk of errors. Shifting registration out of the waiting room can also help protect patients and staff from infection. But these survey results suggest that many patients are still completing registration in person. Providers should consider offering faster alternative options to those that want them, especially as waiting rooms fill up. With Experian Health’s Registration Accelerator, patients can complete intake forms from their mobile devices, anywhere and anytime. Details can be pre-filled automatically to save time and reduce errors, resulting in an easier intake experience with fewer issues for staff to resolve. By reducing administrative overhead, self-service tools can help providers manage unpredictable patient numbers and avoid bottlenecks during busy times. Automated patient registration for a more streamlined patient experience The current crisis magnifies the need for automated patient intake solutions, but patient access is already evolving. More than 8 in 10 providers say their patients prefer an online registration experience, according to Experian Health’s State of Patient Access 2.0 survey. In another report, 6 in 10 patients said they’d switch providers to one that offers a patient portal. Providers must open their digital front door or risk losing patients to competitors. A seamless patient intake experience that integrates scheduling, registration and payment systems will make patients feel taken care of. With user-friendly interfaces, automated appointment reminders and pre-filled insurance information, Registration Accelerator offers patients the speed and convenience that today’s consumers have come to expect. Patients can initiate registration with one click, then upload photos of their driver’s license and insurance card. Optical character recognition technology captures the necessary identity and insurance details, so patients and staff don’t have to fill it out manually. Patients can check their details and confirm appointments before completing authorization and consent forms. They don’t have to spend a minute more on registration than necessary and are less likely to miss appointments, leading to faster care. Maximize operational efficiency with automated patient registration solutions Registration Accelerator integrates with other automated patient-facing intake tools, such as Patient Scheduling and Patient Financial Advisor, to create a frictionless experience. Giving patients more control is not only more satisfying and convenient for them, but it also helps drive efficiency – which is increasingly important as hospitals reach capacity. Using digital systems instead of manual processes also enables easier integration with other data management systems, such as electronic medical records, hospital information systems and eCare NEXT®. Data need only be added once, which reduces the burden on staff and helps to avoid errors arising from ineligible handwriting. In addition to having greater confidence in the integrity of their data, providers can also use patient intake software to generate performance reports, revealing further opportunities to improve efficiency. Providers can allocate staff to high-priority tasks and use customizable workflows to maintain operational standards. The impact on the bottom line can be significant. Automated registration solutions reduce administrative costs. But perhaps more importantly, they prevent delays in reimbursement by avoiding time-consuming errors and inefficiencies. In this way, faster registration leads to earlier care, with better outcomes for both patients and providers. Find out more about how Registration Accelerator can ease the pressure on providers by speeding up patient intake during the busy winter period.

Whether by necessity or choice, the way patients navigate the healthcare payments system has transformed over the last few years. Healthcare’s digital front door swung open during the pandemic, offering patients far greater choice and flexibility in their use of digital payment methods. New legislation around surprise billing and transparent pricing gave patients greater visibility into the cost of care, improving their ability to plan for their financial responsibility. Many individuals switched between health plans and became responsible for a greater percentage of their healthcare bills. And the economic downturn continues to exert pressure on patients’ ability to pay, causing concern to patients and providers alike. Patient payment software can help ease these challenges. In this context, providers looking to attract and retain loyal patients must ensure the patient payments experience aligns with these changing needs and expectations. Clear communication, straightforward billing procedures and seamless payment options are essential to make it easier for patients to pay and protect provider profits. Here are 5 ways the right patient payment software can create a more satisfying patient experience and accelerate collections. 1. Offer clear and transparent medical billing processes As deductibles, co-payments and co-insurance arrangements become more complex, calculating patient financial responsibility is more challenging. Patients may find it hard to gauge what their final bill will be, prompting some to delay payments or even forego care altogether. A study by Experian Health and PYMNTS found that 46% of patients had canceled care after receiving a high-cost estimate, while 19% had experienced financial distress after spending more than they could afford on healthcare. Accessible, easy-to-understand billing procedures give patients a sense of control and encourage engagement in the healthcare process. This starts with reliable price estimates. In fact, around 60% of patients who received inaccurate pricing estimates would consider switching providers. With digital tools such as Patient Payment Estimates, providers can generate accurate estimates and give patients a clear breakdown of their financial responsibility before they come in for care. They also have the option to make secure payments via their mobile device. At the same time, insurance coverage discovery tools can be used to verify the patient’s insurance coverage and check for any forgotten coverage, so they have a better idea of what payer(s) will cover. Not only does this make the billing process more transparent and manageable for patients (resulting in faster payments for providers), but it also helps providers comply with new price transparency regulations. 2. Deliver flexible patient payment options Experian Health’s State of Patient Access surveys confirmed that patients want choice and control when it comes to paying for care. Experian Health President Tom Cox notes that “digital-first consumers are digital-first patients.” They want to see the “Amazon experience” replicated in their healthcare payments experience: “I will tell you, for myself as a patient, I much prefer to pay before I get there. Or I’d like to pay when I leave so that I don’t have to get the bill. If I do get the bill, I want to be able to pay online. What I don’t want is to fill out the slip with a check — the worst — or my credit card information and mail it to someone.” Digital payment methods can help providers remove friction in the payment experience by giving patients 24/7, self-service payment options, with options to pay by credit card, mobile wallets, online portals and peer-to-peer services. Experian Health’s suite of Patient Payment Solutions gives patients the flexibility they crave while helping providers increase patient satisfaction and accelerate collections. 3. Prioritize a personalized financial experience Just as there’s no one-size-fits-all remedy when it comes to clinical care, financial options must be tailored for each patient. Some patients will be willing and able to pay their bills in full and be keen to do so pre-service so they can forget about billing and focus on their health. Some may need to spread out payments into manageable chunks. Others may have no means of paying and feel unsure about their options. Patient Financial Clearance gives providers the data they need to customize payment plans based on each patient’s individual financial circumstances. With PatientSimple, patients can manage their payment plan through a user-friendly self-service portal, which allows them to generate pricing estimates, update insurance information, store credit card details, apply for charity care, combine payments to different providers and schedule appointments. This personalized service helps providers avoid missed payments and reduces the risk of having to involve multiple collections agencies, as patients have more confidence in their capacity to meet their financial responsibility. 4. Reduce patients’ financial worries While the uninsured rate has dropped, there are still more than 27 million Americans without health coverage. More will potentially lose coverage when the COVID-19 public health emergency ends. But even those with coverage may still worry about being able to pay for their out-of-pocket costs. Coverage Discovery runs automated checks to scan for any missing or forgotten billable coverage. Accounting for all possible coverage often reduces the patient’s financial responsibility and the accompanying anxiety that comes with a higher medical bill. Automation can also be used to pull together information from a provider’s chargemaster, claims history, payer contracts and patient benefits to generate accurate good faith estimates of the patient’s financial responsibility, which can eliminate ambiguity and help a patient better prepare for what they may owe. Read the report from Experian Health and PYMNTS, The Healthcare Conundrum: The impact of unexpected patient costs on care. 5. Improve operational performance Automation and digital tools also support operational efficiencies. Time-consuming manual tasks can be reduced or eliminated, allowing staff to focus on activities that need a human eye, or to support patients who need more personal assistance. Automation also reduces the risk of error, which can lead to contested bills and more work for staff to resubmit denied claims. For example, Kootenai Health used Patient Financial Clearance to automate presumptive charity checks and streamline a clunky workflow. They observed an overall accuracy of 88% in assigning patients to the right financial assistance program, reducing the number of accounts written off to bad debt. Sixty hours of staff time were saved, which were re-directed to priority tasks, eliminating unnecessary paperwork and improving the patient experience. Similarly, self-service payments allow patients to pay quickly and easily with minimum interaction with their providers. Not only does this reduce the burden on staff, but it also improves the patient’s financial journey. Patient payment software can increase satisfaction and accelerate collections What’s clear in these examples is that patient payment software and automation lead to faster, more flexible, and friction-free payment experiences for patients, while increasing recovery rates and operational efficiencies for providers. Find out how Experian Health’s Patient Payment Solutions help healthcare organizations reinvent patient billing and collections to boost revenue and improve patient satisfaction.