Tag: collections
Experian Health products referenced in this blog post: Patient Financial Clearance Coverage Discovery Collections Optimization Manager Healthcare may be historically more recession-resistant that other industries, but the COVID-19 pandemic has left many providers hurting financially, as many patients struggle to pay their bills. Patient collections were already a challenge, with declining Medicaid coverage and rising co-pay obligations putting patients on the hook for more of their healthcare expenses. Now, with millions of Americans out of work and missing out on employer-sponsored insurance, providers are being forced to adapt their collections processes to fit this unstable insurance landscape, or risk losing more dollars to bad debt. Four key strategies can help providers seal the cracks in patient collections and stem the surge in uncompensated care. With compassionate processes that treat each patient as an individual, providers can use data and automation for more efficient healthcare charity screening, find missing coverage and identify both propensity to pay and the best financial pathway to minimize the chances of bills going unpaid. 1. Screen for charity eligibility early and often Nearly 4 in 10 unemployed Americans have been without work for more than 27 weeks – the most since November 2013. As unemployment persists and benefits dwindle for many, more patients may be eligible for charitable support to cover their healthcare costs. Running presumptive healthcare charity screening as part of the collections workflow can help providers identify those who should be getting extra support. Patient Financial Clearance runs automated checks when a patient registers, so individuals can be automatically enrolled as soon as eligibility is confirmed. Checks are repeated throughout the patient journey, should their financial situation changes. Caye Mauney, Patient Access Director for Palo Pinto General Hospital, says the automated checks can confirm eligibility within just three seconds. This saves a huge amount of time for her team, while giving patients financial clarity without worrying waits: “All the information we need is now at our fingertips. The patient no longer needs to bring in check stubs or go back to a former employer to ask for information. It’s been a game changer.” 2. Find forgotten coverage quickly Automation can help providers cut uncompensated care by finding missing and forgotten coverage, even when patient case mix and payer rules are constantly changing. Healthcare organizations that quickly uncover previously unidentified coverage are often are paid sooner and avoid the collections challenges of self-pay receivables. Experian Health’s Coverage Discovery uses best practices around search, historical information, multiple proprietary data sources and demographic validation to find previously unknown coverage. It continuously scans for insurance coverage to maximize reimbursements and minimize accounts sent to collections and to charity. Learn from Banner Health how Coverage Discovery has helped the organization find 30+% unidentified coverage earlier in the revenue cycle. 3. Improve the collections experience with compassionate billing Speedy coverage checks are just one way to give patients peace of mind when it comes to medical expenses. The collections process is often opaque and intimidating, hitting patients when they’re already stressed and vulnerable. The more compassion that can be built in, the better the patient financial experience will be. Unpaid bills go down, while patient loyalty goes up. Transparent pricing, data-driven payment plans, personalized communications, and easy ways to pay all contribute to a positive patient financial experience. A good place to start is with Collections Optimization Manager, which allows providers to segment, support and monitor patients throughout the entire collections cycle. By connecting to a host of other patient-facing tools, this helps members feel taken care of from start to finish. 4. Use data to put patients on best payment pathway None of these strategies will work without reliable, accurate data. Healthcare organizations traditionally rely on demographic and behavioral datasets, but this leaves gaps in how much is known about patients’ financial situations. Incorporating credit data can add a layer of valuable insights about a patient’s propensity to pay, so collections resources can be directed to the appropriate accounts. If it is clear a patient has a missed mortgage payment or delinquent loans, providers can help them find alternative coverage and redirect them to a better payment pathway. Experian Health combines demographic, behavioral and credit data so providers can help patients navigate their health expenses with confidence. The result? Better financial health for all. Find out more about how to optimize patient collections, whatever 2021 has in store, in our recent eBook, Recession-proof your revenue cycle.
There is no question that providers’ bottom line has been hit hard this year, and a new surge in COVID-19 is bound to threaten hospital finances once again. As healthcare providers look to supercharge their payment velocity during these uncertain times, it’s worth taking a step back to examine the revenue cycle management process as a whole: what it is, how it works, and the clear actions providers can take to improve the process overall. Below is an overview of healthcare revenue cycle management and how specifically providers can improve their bottom line now and after the pandemic subsides. What is revenue cycle management? Any business, regardless of industry, needs to develop successful processes and strategies for remaining financially healthy. For hospitals and health systems, that process is revenue cycle management. To run a successful healthcare organization, providers must employ and manage accurate and efficient billing processes. Without it, these organizations will likely have to close their doors and will, as a result, no longer be able to provide quality care for their patient population. How revenue cycle management works in healthcare To put it simply, in order to generate revenue for their organization, providers need to collect payments for services rendered. The process of doing this, however, isn’t always as straightforward and simple as it seems. Think of healthcare revenue cycle management like a journey. It starts when a patient schedules an appointment and ends when all patient payments for medical service(s) received have been collected. As we move through the journey, providers have a lot to manage, starting first with front-end intake process, moving all the way through the back-office operations to ensure payment is ultimately secured. Phases of the revenue cycle management life cycle The revenue cycle management life cycle spans several phases: Schedule visit and secure estimate. To kickstart the process, a patient will book an appointment with a provider or specialist and administrative staff will handle insurance eligibility verification and ultimately establish a patient account for that organization. This is also an opportunity for providers to offer price transparency and provide an estimate for services to be rendered. Registration and check-in. An early and vital step for optimizing the entire revenue cycle management process, this is where providers capture details like medical history, insurance coverage and other patient demographics. Ensuring correct patient information on the front end reduces the errors that cause rework in the back office. Ensure care is authorized by the payer. Still on the front end, this is where provider staff checks whether prior authorization is required for a particular procedure or service. Not securing authorization in advance of service can lead to costly denials, rework, operational inefficiencies, and a poor patient experience. Receive treatment and discharge. Once the patient is discharged, the services provided will be translated into billable charges and a medical billing code will be assigned to the claim. It is crucial to the revenue cycle that these claims be accurately coded, as the re-work for incorrect codes and subsequent claim rejections can be costly and a drain for productivity. Medical claims submitted. The claim must then be submitted to the payer. Submitting accurate and timely claims maximizes the revenue collected and prevents delays in reimbursement. Rejected claims directly affect an organization’s revenue cycle, making it all the more important to get the claim right before it makes its way to the payer. Even if a claim is denied, is important it be resubmitted as quick as possible. Patient payments and collections. Once insurance reviews the claim and provides their reimbursement, patients are presented with their out-of-pocket costs for services rendered. On-time payments made in full are preferable for a healthy revenue cycle, but that isn’t always feasible for patients, especially now given the current environment with COVID-19. This is where quality collections practices can really help to optimize patient payments and reduce bad debt. Challenges in revenue cycle management Any process with this number of touch points is bound to come with challenges, but two major challenges seem to stand out: claims and collections. Navigating healthcare claims is complex and costly. Providers and facilities often get stuck in a cycle of inaccurate claim submissions, denials, corrections and rebilling that delays reimbursement and negatively impacts financial performance. A lot of denials can be traced back to errors within the claim submission: improper coding, issues with insurance eligibility, missing or inaccurate patient information, or duplicate claim submission. Errors like this on the front-end are a major cause of the headaches experienced by providers further down the line. After claims are submitted, provider staff will monitor and keep track of claim status. Surprisingly, many still use a manual process not only for this, but for managing any claims that are ultimately denied. Without any kind of automation, this is a drain on productivity, time and resources and it becomes more difficult for providers to respond to denied, pending or returned claims in a timely manner for reimbursement. Another prominent challenge in the revenue cycle is collections, notably collecting from patients before or at the point of service. Providers would prefer to collect from patients prior to them leaving the office, but it’s not always possible, and for a few reasons. Patients are increasingly unable to pay their medical bills, more are presenting as self-pay (maybe now more than ever during the pandemic), and some may not be aware of subsequent coverage or that they qualify for charity assistance, all which directly impact providers’ abilities to collect. A lack of price transparency for services can make it even more difficult for patients to prepare financially. Benefits of revenue cycle management Despite its challenges, when done right, there are many benefits of revenue cycle management in healthcare. Effective revenue cycle management not only improves the patient experience but improves staff satisfaction as well. Automating the process (billing, coding, claims management, etc.) reduces a lot of the associated administrative burden, which allows providers to focus on the delivery of quality care. An optimized revenue cycle will also lower the rate of denials. As errors and redundancies are addressed and prevented on the front end, fewer claims will be denied. Maybe one of the most obvious benefits of a healthy revenue cycle is maximized collections and revenue, and faster collection processes, especially when the process is automized. The entire collections process can be expedited, lowering administrative burden while also improving accuracy. How to improve your revenue cycle management We recommend providers take a holistic approach to improving revenue cycle management, focusing largely on automating the process and within the following four areas: Automate access Patient access is the starting point for the entire revenue cycle process. Ensuring correct patient information on the front end reduces the errors that cause rework in the back office. patient access. With an automated, data-driven workflow, providers can reduce the errors that lead to claim denials while simultaneously improving access to care for patients through capabilities like online scheduling. Access is further improved by reducing the friction around patient billing by leveraging real-time eligibility verification to deliver accurate patient estimates at registration. Increase collections There is a definitely a delicate balance between ensuring that debts are collected and fostering a positive patient financial experience. It is imperative providers find a way to maximize patient collections while also increasing patient satisfaction. Patient access staff must be the patient’s advocate while also improving the organization’s ability to collect from the patient and payer. By leveraging a data-driven approach, staff can verify patient identity and insurance coverage as well as provide an accurate estimate of payment responsibility ahead of service. Staff even can review data to assess ability to pay and evaluate various payment plan and/or financial assistance options. The further upstream the revenue cycle can be managed the more effective the process will be to ensure the patients are informed prior to service, so they can make their portion of their payment responsibilities as early as possible to accelerate the cash collections for providers and to reduce the need to put significant effort into late stage collections. Streamline claims Providers can improve financial performance with automated, clean and data-driven medical claims management. By integrating claims management software with customized edits into the workflow system, providers can thoroughly review every line of every encounter and verify that each claim is coded properly and contains the correct information before the claim is invoiced and submitted for reimbursement. Encounters can be processed in real time with automatic alerts for incorrect codes or other potential issues before the claims submission. Responses include a detailed explanation of why a claim was flagged, so any necessary modifications can be made prior to submission. Increase reimbursement Healthcare organizations that don’t stay current on payer policy and procedure changes risk payment delays and lost revenue. It can also be difficult for providers to verify the accuracy of payment received from third-party payers. With automated access to the right data, providers can be reimbursed more accurately and quickly, while also strengthening their relationships with payers. Providers can avoid payment delays and lost revenue with automated payer policy and procedure change notifications. Solutions that continuously audit payer contract performance can assure that collections align with negotiated terms. The key for successful revenue cycle management Technology, specifically data and automation, is key to the success of the healthcare revenue cycle. Automation ensures problems don’t continue to effect productivity, and data can be matched precisely to predict, model and optimize financial results. Both can also be used to highlight a patient’s financial situation, as well as their propensity to pay, allowing providers to optimize collection strategies from the start and get patients on the right programs.
As 2020 draws to a close and headlines hint that the end might finally be in sight for the pandemic, the healthcare industry is considering COVID-19’s legacy. The sudden shift to contactless care, financial consequences of widespread social distancing measures and changing expectations of the patient experience have upended the world of healthcare and health IT – but which changes are here to stay? And what do these changes mean for the patient experience in 2021? We asked several leaders across Experian Health for their predictions in the areas of patient access, collections, and identity management, and here is a preview of what they had to say: “Patients will choose providers that give them control over their healthcare experience” Patients have more opportunity today than ever before to manage their healthcare experience from the comfort of their own home, whether that be through patient portals, online self-scheduling and registration or online payment tools. As lockdowns and social distancing prevented patients from presenting in person, providers were forced to offer patients with more options for self-service. Unsurprisingly, this was a move a lot of patients have been waiting for and many welcomed this new technology with open arms. Jason Kressel, senior vice president of consumer products and analytics at Experian Health, expects that, as patients become more accustomed to this level of self-service, more than half of consumers will change providers in favor of one that offers premium digital healthcare services: “Providers who can meet patients where they are—through web-based services and via their mobile devices—will have the most success with retaining and attracting patients.” Online self-scheduling can put patients in the driver seat while also avoiding unnecessary contact while many remain cautious about on-site visits. With access issues removed, the patient experience will improve, in turn improving health outcomes (and providers’ bottom lines!). “With hospital finances on shaky ground, collections will be a top priority for survival” As COVID-related unemployment leads to an unstable insurance landscape, many providers are worried about maintaining effective collections processes, and they cannot afford to spend time chasing payments. Guarding against uncompensated care and tightening up the collections process will be essential. Automated collections software can help collections teams focus their efforts on patients who are most likely to pay, while also helping patients manage their financial obligations with as little stress as possible. Providers can also quickly determine which patients qualify for financial assistance, helping them get them on the right payment pathway for their circumstance without delay. Not only will this provide a much better patient financial experience, it’ll prevent “lost coverage” and allow providers to collect a larger portion of dollars owed. “The surge in portal usage means providers need to watch out for fraudsters” What does the rapid growth in portal uptake mean for data security? The speedy rollout of telehealth and other digital services has exposed security concerns for many providers, who fear a rise in fraudulent activity in 2021 as cybercriminals sniff out opportunities to steal patient data. To protect patient information and avoid costly reputational damage, providers must adopt more sophisticated identity management solutions. By combining cutting edge identity proofing, risk-based authentication and knowledge-based questions, providers can more easily verify a patient’s identity when they log on to their portal, greatly eliminating the risk of fraud. Interested in learning more about other trends that could affect the patient experience moving forward?
How did Starbucks lose $1.2 billion in sales during the pandemic, but still exceed revenue expectations in the last quarter? The answer lies in contactless mobile payments. By making it possible for coffee lovers to pre-order and pay for their morning cappuccino through a mobile app, the company was able to offer a safe and convenient slice of normality during the pandemic. While stores were limited to drive-thru and takeout, customers could still get their caffeine fix, but in an easy, socially distanced way. And customers want convenient and contactless ways to pay – as evidenced by $6.2 billion in quarterly sales. Thanks to the app introduced a few years ago, the company has been able to withstand much of the disruption that’s hit the rest of the industry hard. Can healthcare providers learn from Starbucks’ strategy? Yes. Social distancing measures and fears about face-to-face contact are preventing many patients from visiting healthcare facilities and it’s becoming harder for providers to collect payments and maintain a steady revenue cycle. Self-service and contactless payment methods are now a necessity if providers want to remain profitable during these uncertain times. But it’s not just about facilitating payments in the context of social distancing. Even before the pandemic, patients were looking for more convenient ways to manage their out-of-pocket expenses and thinking more like active consumers than passive participants in their healthcare journey. Starbucks’ story shows how prioritizing the consumer experience wins out in the end. So how do providers accelerate collections, ensure patients and staff remain safe, and keep up with consumer expectations? Here are three ways to use pre- and post-service online and mobile payment tools to optimize both collections and consumer satisfaction: 3 ways to improve the patient financial journey with easy contactless payments 1. Empower patients with upfront payment estimates Imagine sending patients an email or text as soon as their appointment is scheduled, with a personalized cost estimate, relevant payment options and convenient ways to pay before they even arrive. Healthcare payments could be as easy as ordering and paying for a coffee! With Patient Financial Advisor and Patient Estimates, providers can do just that. With a single text message, providers can give patients transparency, control and reassurance about what they’re going to owe and how they can settle their bill quickly and easily. 2. Help patients find the right payment plan The pandemic means finances are tighter than usual for many families as well as many organizations, so helping patients manage their bills and get on the right plan pre-service is especially important. With a consumer-friendly online portal, patients can check their balances, manage payment plans and apply for financial support at the tap of a button. Quicker insurance checks will also increase the likelihood of faster payments and minimize the risk of claim denials for providers. 3. Make it easy to pay – before or after treatment Reducing friction at the point of payment is probably the biggest dial-mover when it comes to accelerating collections. If patients can settle their bill at the click of a button, the job is ticked off quickly without too much effort on their part, and with minimal input from providers taff. Why make paying harder than it needs to be? Consider offering patients safe and secure digital payment methods that they can access anytime, anywhere, both before and after their appointment. Post-service, maintain a positive consumer experience with proactive follow-up, timely account information and options to navigate payments from home, if not already settled. The pandemic has intensified the need for healthcare payments to evolve. Contactless and mobile payments can keep revenue coming in the door (even when the real doors are shut). And as Starbucks has shown, consumers expect easier ways to pay. Every day that a patient struggles to pay a bill is a missed opportunity for the bottom line. Find out more about how pre- and post-service contactless payments could help your organization withstand financial turbulence, during the pandemic and beyond.
With high-deductible health plans, larger out of pocket costs, and confusion about medical costs in general, it’s no surprise that patients today face increased financial responsibility. Unfortunately, the current pandemic has introduced an entirely new level of financial responsibility and uncertainty for both patients and providers. Like many provider organizations across the country, Yale New Haven Health was feeling the impact of the changing healthcare landscape. Patients are finding it harder and harder to pay their medical bills, and more accounts are going to debt. The organization obviously needed to be compensated for their services and improve collections, but it needed to do so in a way that matched its mission and vision of providing high value, patient-centered care. A few years ago, Yale New Haven Health turned to Experian Health to improve collections with an elevated patient experience. With Experian Health’s Collections Optimization Manager, Yale New Haven Health was able to score and segment patient accounts based on who has the propensity to pay, determine how a patient could best resolve their bill and then direct them to the appropriate resources for doing so. The organization supplemented this activity with PatientDial, a cloud-based dialing platform that offers inbound and outbound communication options to increase collections. While these efforts have improved collections for the organization in the past, they have proven invaluable for both the revenue cycle and the patient experience during COVID-19. Increased patient satisfaction. A billing indicator was included for patients that might be experiencing financial hardship as a result of COVID-19, allowing the organization to hold that particular billing statement for 90 days. After 90 days, those accounts were again reviewed and evaluated for charity care as necessary. Patients have been grateful for the extra time and flexibility for payment during such a stressful event. Continued collections. With these steps in place, Yale New Haven Health was able to maintain the regular daily statement production and movement of accounts through the revenue cycle for those not experiencing COVID-related hardship. The additional revenue supported the institution and helped to maintain collection levels as close to normal as possible during uncertain times. Improved communications. Even with the 90-day delay for select accounts, call campaigns with PatientDial continued throughout the pandemic. Connection rates have increased by 5.5% month over month from January to present. Patients are not only pleased with the communications over balances due but are more receptive to attempts to resolve debt as the organization has approached billing-related communications in a more empathetic manner.
While all hospitals and health systems will no doubt encounter revenue-specific challenges related to the pandemic, a solid foundation and targeted approach for improved collections can help speed up the road to recovery. In fact, it was Sanford Health’s unique approach to increasing patient collections that allowed it to both optimize collections during the pandemic and improve employee satisfaction and retention. Several years prior to COVID-19, Sanford took steps to improve collections with a patient-focused, hybrid approach that combines employee incentives with segmentation strategies. Leveraging Collections Optimization Manager and PatientDial from Experian Health, Sanford was able to quickly and easily streamline call center operations and increase collections in a myriad of ways – through new and updated patient addresses, patient-friendly billing statements, identifying new guarantors and more. With the above items in place, Sanford was already well positioned to seamlessly manage normal business operations during a pandemic. The organization was able to quickly adapt, and then build on that momentum to better serve its patients and staff, while also driving results. Since the start of COVID-19, Sanford has: Increased employee satisfaction with remote capabilities PatientDial allowed Sanford to seamlessly transition its call center team to work remote. Where about 30% of the workforce was remote prior to COVID-19, just shy of 99% of call center representatives are now remote. This has been a great source of employee satisfaction and safety and has aided in the system’s ability to keep the collections momentum going. Provided a more compassionate approach to collections Recognizing that this is a sensitive time for many, Sanford ensured the proper mechanisms were in place to identify those who required additional help, offering the best methods for collection possible. Sanford has not only created a billing indicator for patients affected by COVID-19, but Experian Health has provided additional insight with a weekly file of patients who are identified as possibly financially stressed. Improved collections during time of crisis While collections decreased for the quarter, Sanford saw a record increase in collections for the month of March -- $800K more than the system saw in March of 2019.
Before working with Experian Health, call center operations at Sanford Health were disparate and disjointed, with each call center operating on a different phone system with different carriers. While some centers saw high abandonment rates, others were waiting around for calls. Although Sanford attempted to create balance by placing accounts in a work queue, the process for managing outbound collection calls remained manual and it was impossible to identify and strategically contact patients based on ability to pay. Sanford took steps to improve collections with a patient-focused, hybrid approach that combines employee incentives with segmentation strategies. Since working with Experian Health, Sanford now has a focused approach to managing accounts receivable (AR) by identifying patients with a certain propensity to pay. Collections Optimization Manager allows Sanford to quickly identify a pathway and delivery to resolution of the patient’s balance. The analytical segmentation models within Collections Optimization Manager use precise algorithms that reveal those patients who likely are eligible for charity services, those who might prefer to pay in full at a discount, or those who might benefit from a payment plan. The solution then feeds segmentation data to PatientDial, which Sanford uses to route calls to 70 patient account representatives. Sanford also implemented a re-designed, more user-friendly patient statement format. The improved cover page offers easy-to-understand information about the bill including the available options for payment. In a larger effort to improve the patient experience, Sanford implemented an employee incentive program that appropriately rewards staff based on their collections’ performance. Since working with Experian Health, Sanford has seen the following improvements: Streamlined call center operations. With PatientDial in place, Sanford was able to consolidate its call center team members in 4 regions and seamlessly operate on centralized toll free and direct dial numbers. Where it used to take on average 56 seconds for a call to be answered, calls are now answered in 20 seconds or less. The system now comfortably manages an average of 12,000 inbound calls weekly. Increased collections. The model in place has allowed Sanford to improve collections in a myriad of ways. In addition to increased collections from calls made through PatientDial, Sanford was able to see an additional $2.5M in patient payments by ensuring patient statements were sent to the new or correct address. The system found an additional $60K by identifying new guarantors for accounts of deceased patients. The segmentation capabilities from Experian Health also enabled Sanford to identify patients struggling with bankruptcy, allowing staff to focus their efforts on collectible accounts and more efficiently direct individuals to charity options. Learn more about Sanford Health’s journey and how a similar approach could help your organization improve collections and employee satisfaction.
By January 2021, millions of those who suffered job losses in the wake of COVID-19 will see their unemployment insurance end. Medicaid and subsidized coverage under the Affordable Care Act (ACA) will be a safety net for many, but nearly 2 million Americans could find themselves stuck in the ‘coverage gap’, where their household income exceeds the eligibility threshold for Medicaid, yet falls below the lower limit required to receive ACA marketplace subsidies. Without large group or government coverage, these consumers will be left uninsured or forced to purchase individual plans with high deductibles. Considering this will likely contribute to larger patient balances and more struggles with patient collections, many are bracing for a hit to their bottom line. To help minimize accounts receivable and avoid bad debt write-offs, choosing the right data model should be a top priority. Here, we look at one piece that’s often missing from the patient collections puzzle: credit data. Don’t overlook credit data in your self-pay collections strategy Many providers already use demographic and behavioral data to power patient collections, but there can be gaps in what’s known about a consumer’s ability to pay. Credit data can help fill in the blanks. Here are three ways this can be used to optimize your collections strategy: 1. Get a complete view of your patients’ financial situation for faster decision-making Credit data can reveal how a patient is managing other financial obligations, giving you insights about how to handle their healthcare account for a greater chance of payment. Have they just maxed out a credit card? Have they missed a student loan payment or fallen behind on their mortgage? If so, they’re probably going to find it difficult to pay off their medical bill. Knowing this, you can move quickly to help them find alternative coverage or offer a more manageable payment plan. Conversely, if they’ve just bought a new car or paid off a personal loan, there’s a high chance they’re in a good position to pay their medical bills too, so contacting them with a straightforward and easy payment plan means they can clear their balance promptly. 2. Segment patient accounts and allocate them to the right payment pathway The sooner you can get patients onto the right payment pathway, the more robust your cashflow will be. Credit data can help you segment accounts quickly and accurately. Experian Health data shows that when patients are segmented according to propensity to pay, collections increase by around 2% when credit data is included, compared to segmentation without credit data. Martin Health System used Collections Optimization Manager to segment patients and check for available charity support or Medicaid eligibility. By getting patients on the right pathway and making sure agencies were focusing on the right accounts, they increased recovery rates by more than $3.1 million and identified an extra $975,000 in Medicaid coverage in just seven months. 3. Create a more compassionate patient financial experience Using credit data also helps create a more compassionate patient financial experience. Instead of adding to a patient’s financial worries by chasing payments they’ll never be able to cover, you can run charity checks to see if there’s any missed coverage and quickly connect them to the right financial assistance program. A tool such as Collections Optimization Manager lets you segment patients based on their individual circumstances, for a more patient-friendly approach to collections. You can then personalize their communications and payment options so they can manage their expenses with less anxiety and more confidence. Discover why 60% of US hospitals are already using Experian Health’s advanced collections software and unrivaled datasets to optimize patient collections, and find out how we can help you build a resilient revenue cycle as self-pay accounts continue to rise.
The President, members of Congress and consumer advocates are all demanding price transparency within the healthcare universe. The major push of late is President Trump’s executive order that will be issued in June 2019; while critics hope this initiative will fade, the topic has been on the industry radar for many, many years. How did we get to today’s scenario? We have a robust perspective on this subject at Experian Health because we’ve been working with healthcare organizations offering various solutions that inform consumers about the costs of their care for more than 10 years. We brought to market the first iteration of our current Patient Estimates product back in 2008, responding, in part, to the growing issue of medical debt and inherent risk to providers not getting full payment for services. The challenges presented by medical debt are well documented, but the important point to focus on is that as long as Americans continue to lack the ability to pay for their care and health organizations struggle with collections, the push towards price transparency will continue. Perhaps this is much needed progress? Since 1957, nearly 75% of Americans have consistently reported being insured but unable to pay their medical bills, according to a study by the Centers for Disease Control. Now, more than 50 years later, many legislators hope mandated price transparency will alleviate the surprise factor of medical costs and spur a more competitive environment. In 2008, helping patients understand their costs was intended to improve providers’ collections success. The term ‘price transparency,’ with additional connotations (e.g. better experience for the patient, improved efficiencies), popped up about the same time as the introduction of very high deductible health plans. The phrase started gaining traction following passage of the Affordable Care Act, and as patients were responsible for more of their medical costs. Add in the rise of consumerism within healthcare and Americans’ digital lifestyles, and it’s no surprise there are calls for pricing to be as easy to understand as they are in the retail space. We harness the power of data and analytics to fulfill these needs in the marketplace. The healthcare industry was ripe for change more than a decade ago, as evidenced by the desire of organizations to leverage what we could offer. While there is continued debate on the transparency topic, the good news is today’s data-driven technology can create a patient financial experience that is friendly, understandable and accessible, delivering the good-faith estimates many consumers, legislators and the industry-at-large wish to see. Consumerism drives price transparency expectations Ultimately, the financial aspect to care is a key component to consumers’ satisfaction with a provider. This realization began to bubble to the surface over the last several years. In fact, Experian Health conducted research last year to understand consumer pain points during the healthcare journey. Consequently, it was no surprise when the study revealed consumers’ biggest frustrations and challenges – above clinical areas – is dealing with the financial aspects of healthcare: 90 percent of respondents ranked worrying about paying their medical bills as a very important to extremely important pain point. 30 percent acknowledged the challenges of determining what financial support options (e.g., payment plans, government grants, and hospital charity care programs) are available 90 percent reported significantly underestimating the costs associated with major medical procedures (e.g., knee replacement) The takeaway from this study is clear: consumers want a streamlined payment process that builds confidence and provides peace of mind. We know that healthcare providers want to increase the efficiency and success of their collections efforts. Ultimately, everyone benefits from clarity around pricing. So whether government-mandated or not, there is no denying that price transparency, in some form, is here to stay and a transformation in the industry is taking hold. Experian Health is leading the way to innovations that will help healthcare organizations thrive in this new era. By leveraging our expertise in data and analytics and our understanding of healthcare costs, we can help patients successfully navigate their financial obligations from primary care appointments through subsequent diagnostic procedures and surgeries. The potential is there for everyone to benefit from an evolved, modern system. Related Articles: How Blessing Health System personalized estimates to improve patient satisfaction How to make price transparency less confusing for patients
