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As inflation puts the squeeze on families and individuals, healthcare providers have an opportunity to reimagine the patient financial experience so that medical bills put less stress on a household’s finances. Consumer-friendly changes might include providing estimates, clarifying benefits statements, offering payment plans, providing digital tools to make payments more convenient and offering more payment options. Not only would this help patients manage their medical bills so they feel more in control of their finances, but it would also help ensure that healthcare providers get paid faster and more reliably. Treating patients more like customers might actually boost the bottom line. In fact, a recent study from Experian and PYMNTS revealed that 6 out of 10 patients who paid out-of-pocket healthcare costs and received either an inaccurate cost estimate or an unexpected bill would switch healthcare providers for a better payment experience. “The Healthcare Conundrum: The Impact of Unexpected Patient Costs on Care,” a new report by Experian Health and PYMNTS, surveyed 2,483 consumers to learn about the effects of rising healthcare costs and unexpected medical bills on patient care and satisfaction. The financial challenges for patients Patients have been forced to assume a greater financial burden for healthcare payments through the prevalence of high-deductible healthcare plans. One benefits survey found that 58% of covered workers have at least a $1,000 deductible for single coverage. And due to limited payment options for managing medical costs, many consumers get strapped with large medical debt. More than half of Americans have at least $1,000 in medical debt and more than two-thirds of Americans under 65 report that they struggle with the cost of healthcare. Some consumers even opt to delay or forego medical care because of the cost. The healthcare industry has invested billions of dollars in technology and services that empower patients to play a more active role in the clinical side of their health journeys. Now, providers have an opportunity to do the same with the financial side of healthcare, so patients are empowered to better manage their health costs. 3 investments for a better patient financial experience Experian Health’s State of Patient Access 2.0 survey showed that patients want transparent healthcare pricing, payment plans and support, and faster and more convenient ways to pay their medical bills. “Giving patients transparency and payment options can improve the patient experience,” says Liz Serie, Senior Director of Product Management at Experian Health. She explains that it’s important for providers to improve the financial experience because it will benefit each patient’s overall health journey, increase the likelihood that patients will pay their medical bills, and help build patient loyalty as consumers prefer providers that offer convenient financial tools for patient payments. Experian Health has a suite of tools and services that can help providers improve these aspects of the financial side of healthcare. If providers make these strategic investments in the patient financial experience, they can both grow revenue and increase patient satisfaction. Investment 1: Price transparency Financial transparency is a major issue in healthcare, which results in unexpected or unexpectedly large medical bills. Data from Experian and PYMNTS revealed that in the past 12 months, 43% of patients who received inaccurate cost estimates and 40% of those who received an unexpected bill spent more than they could afford. If providers can offer more price transparency, it will help patients avoid getting stuck with inaccurate, confusing, or nonexistent estimates for their health costs. Tools like Patient Payment Estimates and Patient Financial Advisor can deliver clear estimates to a patient’s mobile device so they can be better informed about their health costs – and be better prepared to manage them. Patient Estimates uses real-time insurance status, contract rates, and provider pricing so the patient gets an accurate breakdown of a pricing estimate on the front-end of their care. This will allow patients to focus on the care they need instead of stressing about price uncertainty. These tools also offer convenient ways for patients to pay their medical bills so they can manage their financial obligations. Investment 2: Customized payment options Consumers expect financing options for larger purchases like cars and appliances, so healthcare providers should consider offering the same.  Personalized payment plans can help patients manage and pay their health bills. PatientSimple identifies the best financial pathway for each individual patient and offers an easy-to-use, self-service portal that helps them navigate that path. Patients can also use this tool to store payment information, set up payment plans, and apply for charity care. Consumers also want digital payment options that give them a fast, flexible, and secure way to make payments. Many consumers report that the pandemic has changed how they prefer to pay for goods and services. They want more contactless options, online portals, and mobile-friendly systems. Experian’s Patient Payment Solutions modernize patient payments through mobile-optimized, self-service options that make it easier and simpler for patients to pay their health bills in whichever way they prefer. Investment 3: Data-driven financial insights Healthcare providers can use data-driven tools like Patient Financial Clearance and Collections Optimization Manager to determine which patients have the financial capacity to pay their medical bills – and which patients might need financial assistance. By tailoring payment plans to each individual patient, providers can improve the financial experience and increase the efficiency and productivity of collections. Consumers have shown that they want convenient and customized payment options for all their purchases – healthcare included. To meet that expectation, providers can leverage technology, data, and analytics, creating the best possible patient payment experiences and improving their own bottom lines. Learn more about Experian Health can help healthcare organizations reimagine the patient financial experience with digital tools and solutions.

Nearly a quarter of patients have received a surprise medical bill, according to new data from Experian Health and PYMNTS. 4 in 10 patients said they ended up spending more on healthcare than they could afford, with the average surprise bill amounting to $675. Even insurance-savvy patients fall foul of surprise billing: 31% of patients who were familiar with the coverage landscape ended up paying more than their estimates suggested. Healthcare providers will need to implement solutions that can generate accurate price estimates before patients seek care, and prevent surprise billing. Without accurate cost estimates, patients are more likely to cancel appointments, which could cause their health conditions to get worse and eventually cost more to treat. This also creates avoidable and expensive administrative work for providers, who must chase payments from growing numbers of anxious, self-pay patients. To prevent surprise billing, healthcare organizations can look to data and digital tools. Advanced analytics provide greater clarity about each patient's financial situation, generate more accurate estimates and improve the patient payment experience. Inaccurate estimates persist despite the No Surprises Act Consumer demand and legislative action on surprise billing have led to an escalation in the push for more accurate estimates. But estimating patient liability is far from simple. It requires complicated calculations based on the patient's coverage, provider charges, payer contracts and potential discounts. Undertaking this manually can be time-consuming and error-prone, so many providers are turning to automated solutions. In a recent conversation with Healthcare Finance News, Jason Considine, Experian Health's Chief Commercial Officer, notes that providers expect to invest more in digital patient estimates solutions, particularly as the regulations expand. Those investments are likely to include technology to deliver accurate estimates and patient-friendly payment methods, and increased use of advanced data analytics to optimize collections. Surprise billing is at odds with a high-quality patient payment experience Beyond compliance, accurate estimates are essential for a positive patient experience. A poor financial experience can leave a bad taste in the patient's mouth, even if the clinical care was outstanding. So, what does that positive experience look like? The key is to think like a consumer: make the billing process as clear, convenient and compassionate as possible. Patients are looking for accurate and up-to-date pricing to be available before they receive care. And clear, and communication around the billing process can help eliminate the shock factor and improve patient collections. For example, providers could integrate a tool such as Patient Estimates, to give patients an accessible, personalized cost breakdown based on real-time pricing and benefit information. Patient Financial Clearance assesses a patient's individual financial circumstances to provide accurate estimates and recommend appropriate payment plans. And pricing information, payment plans and links to secure payment methods can be offered via a range of self-service, mobile-optimized patient payment solutions. El Camino Hospital in California used Patient Estimates to improve price transparency. The Senior Director (Revenue Cycle) said: “We decided to do a soft launch of a patient estimator tool, and the very next day, even without advertising it yet, our patients found the tool on the website and started using it. The feedback was excellent. We're providing a lot more estimates than we could before because it's 24/7 and patients can use it on their mobile device, their laptop or their desktop. Some advice I'd give other hospitals is to think of the patient when you're deciding what to do to best communicate your prices. What would the patient want?” Data-driven technology can prevent surprise billing Tom Cox, President at Experian Health, is optimistic about how the patient payment experience might evolve in the second half of 2022, as shared in a recent PYMNTS publication. He believes improvements come down to having the right data in place: “Payment options are increasingly digital and more convenient, payment plans are more common, and price estimates have become less of a rarity. There is also greater use of non-clinical data to get a broader view of patients and their unique financial solutions. Data, coupled with the right technology, can help providers make sense of it all and enhance the patient journey.” Data-driven technology can help simplify the payment process for patients, from accurate estimates to convenient payment methods. With PatientSimple, providers can leverage Experian's unmatched data and advanced analytics to identify the optimal financial pathway for consumers. It then guides patients toward that pathway through a user-friendly self-service portal. Patient Financial Advisor offers a similar experience via mobile. Patients can avoid the stress of surprise medical billing and plan for upcoming expenses. With tools that allow them to pay medical bills from anywhere, at any time, many patients will pay upfront, speeding up the collections process. Working with a partner such as Experian Health lets providers combine what they already know about their patients with industry-leading technical expertise and payment tools. With support to implement the right data-driven technology, providers can prevent surprise billing, resulting in regulatory compliance, greater revenue opportunities and customer loyalty.

The U.S. is currently struggling with a critical healthcare labor shortage that is impacting every part of the revenue cycle. In fact, the American Hospital Association has deemed this challenge a “national emergency” that is only expected to worsen. Staffing shortages leave healthcare providers vulnerable to reimbursement delays, low morale and negative patient experiences.  As a result, many healthcare providers are leveraging automation to tackle this staffing crisis. Revenue cycle management (RCM) software and analytics can help providers navigate labor shortages by relieving staff of repetitive, process-driven manual tasks and improving operational efficiency. As healthcare labor shortages continue, how can providers maximize the return on their investment in automation? The snowball effect of healthcare labor shortages The first quarter of 2022 ended with a peak of 11.9 million open vacancies in the United States. Just about every industry is feeling the impact of the Great Resignation, driven largely by the fact that more people are reaching retirement age than are entering the labor market. In healthcare, the challenge of attracting and retaining top talent is felt even more acutely – in May 2022, the healthcare vacancy rate was 8.8%, second only to hospitality services. While the pandemic created greater pressures on healthcare staff, chronic understaffing and burnout were already a problem. Now, healthcare workers are contending with the snowball effect of increasing stress, sickness absences, lack of time to train new staff and loss of morale. Potential recruits may be tempted away to industries touting fewer COVID regulations, competitive pay, and more flexible and remote positions. Healthcare providers need smart and creative staffing strategies to close the gaps. Automation should be at the heart of HR contingency planning Providers may look to traditional market forces to solve the staffing challenge. Reducing services, increasing wages, improving working conditions and partnering with local education facilities to attract new staff are all on the table. But tight margins and inflationary pressures limit the options available, and policy changes can take time to be implemented. Automation can help mitigate healthcare labor shortages in three main ways. It can reduce the workload and increase staff capacity, improve operational performance and free up resources that can be reinvested in the workforce, and create better experiences for staff (and patients). Using automation to increase staff capacity Repetitive tasks that follow the same process every time are perfect for automated programs. Shifting the load from staff to software means that fewer team members are needed for those activities, and available staff can focus on more complex issues. Patient access is a good place to start. Many hospitals have already started to scale back care due to severe staffing shortages. Online scheduling and automated registration can ease the burden as patient volumes increase. These self-service tools cut down call center queues and eliminate labor-intensive data entry. With automated pre-registration, the correct information for each patient can be pre-filled and follow them throughout their healthcare journey, so staff no longer lose entire days spent resolving data input errors. Automation can improve operational efficiency, even with labor shortages Automation is more than replacing human effort with software programs: it also strengthens operational performance. Automated revenue cycle tools can complete tasks such as data entry, coverage checks, pre-authorizations and eligibility verifications much faster – and with fewer errors – than staff. If data-driven tasks can be completed with greater accuracy and efficiency, then the entire revenue cycle will move more quickly, leading to faster reimbursement. This is especially obvious when using automation to streamline collections. It doesn’t make sense for staff to pursue all past-due accounts, but with automation and advanced analytics, they can identify the patients most likely to pay and focus their efforts accordingly. Collections Optimization Manager uses multiple data sources to automatically screen and segment accounts, so staff doesn’t waste time chasing the wrong ones. Accounts are then distributed to appropriate collections channels using specific routing and recall rules. With a better understanding of each patient’s financial situation, staff can engage with patients in a more compassionate way and resolve issues without repeated calls and emails. Alongside this, automated patient outreach can provide personalized and convenient communications about patient collections. PatientDial frees up staff from time-consuming calls by providing automated inbound, outbound and blended calls with live agents or automated interactive voice response (IVR) services. “Queue callback” automatically calls patients back when a suitable agent becomes available, maximizing staff time while improving the patient experience. PatientDial also monitors agent performance so managers can make strategic decisions to improve workflow. Using automation to create better user experiences Existing staff may worry that increasing the use of automation could lead to their jobs becoming redundant. This isn’t really the case: while automation and artificial intelligence (AI) allow RCM teams to “do more with less” and reduce the need to recruit additional staff, they should be seen as complementary to rather than replacing staff. By removing time-consuming and tedious tasks, automation creates a better experience for staff. User-friendly interfaces give patient access, claims and billing teams all the information they need to help patients quickly and accurately. And as prior authorizations and payer policy changes change ever more frequently, staff will be relieved to hand over the task of checking each payer’s website to a software program that can complete the job quickly and accurately. Shifting to online and mobile options gives patients a more convenient and satisfying user experience, too. For example, automated self-service tools can be used to give patients upfront estimates about their expected cost of care, and link to convenient payment methods. It’s a quick win for providers who will find it easier to comply with new price transparency rules and makes it easier for patients to clear their bills faster. And the result? A happier workforce, a better patient experience and a healthier revenue cycle. Find out more about how Experian Health’s automated revenue cycle management solutions can help healthcare organizations build resilience and thrive in the face of healthcare labor shortages.