Tag: patient payment
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.
Products referenced in this article: Social Determinants of Health Patient Schedule Member Match Coverage Discovery Patient Financial Advisor Patient Payment Solutions With just a few clicks, patients can book appointments, speak to their doctor, access billing information and pay for care, all without leaving their homes. Online health services have been a lifesaver for many during the pandemic, and the reliance on digital tools has sky-rocketed over the last few months. But for some older consumers who may be less comfortable using digital devices, this shift towards “healthcare from home” feels daunting and isolating. Many seniors are not immersed in the digital culture and navigate life just fine without a touchscreen. The sudden shift in healthcare delivery channels has demanded many to venture into unfamiliar technology in a rushed and urgent manner. Others face barriers related to things like dementia, hearing loss and vision loss. Closing the digital divide Whatever their age, those left out of the digital loop face a higher risk of missed appointments, delayed care and anxiety about how to get tests and treatment. Providers will want to ensure that all of their digital offerings are designed to help patients of every age access care in a way that works for them. That means creating a consumer experience with pathways and channels to suit different patient needs and expectations, including “analog” options for those who aren’t inclined to learn new technologies. 4 ways to make digital health technology more senior-friendly 1. Use data to determine what’s working and what’s not The starting point for providers who want to improve seniors’ digital engagement is to understand how they’re actually using it (or not) right now. Non-clinical data can give insights on technology engagement, lifestyle and socioeconomic circumstances across all ages in a patient population. When providers know what patients are looking for, and where the gaps are, they can tailor their services to meet their patients’ needs. For example, let’s say a proportion of an organization’s older members have smartphones or tablets, but aren’t using them to access their patient portals. It’s likely they have the skills so but may not be aware of the service. This can be solved with a simple omnichannel outreach campaign to provide step-by-step instructions explaining how to get started. One way for providers to capture useful data is with “Z codes” -- the ICD-10-CM codes included in categories Z55-Z65. These identify non-medical factors that may influence a patient’s health status. Utilizing Z codes will enable better tracking of seniors’ needs and identify solutions to improve their health and wellbeing. Providers can also leverage data to better understand seniors’ activity in the continuum of care. Are older patients continually presenting for care at a facility that is out of network? A tool like MemberMatch can deliver these insights in real time, alerting care teams as early as possible so that they can rally around active episodes of care proactively and efficiently. This helps risk-bearing organizations optimize the quality and cost of member activity in the continuum of care, leading to better outcomes for patients and a better bottom line for organizations responsible for their health. 2. Give patients choices about how they access services Adoption of healthcare technology is increasing among older adults: 76% of over 50 say they welcome services to help them “age in place”, or live in one\'s own home and community safely, independently, and comfortably, regardless of age, income, or ability level. At CareMount Medical, 27% of primary care appointments made using Experian Health’s online scheduling tool are initiated by those aged 60 and over. The demand is there; support should follow. That said, an omnichannel approach is still important. Given a choice, more than half of people aged 50 and over prefer their health be managed by a mix of medical professionals and technology. This means giving patients the option to easily schedule appointments by phone. Automated outreach and integration, combined with practice management systems, will ultimately make patient scheduling easier. 3. Make virtual care easier to use More than half of seniors cancelled or delayed appointments due to COVID-19. Despite the promise of safety measures, many are hesitant to return. Virtual care may be the answer. Providers are quick to learn that telehealth is not a panacea, in particular for the senior population. As some patients may not have the technology and skills to access telehealth, providers may want to consider a hybrid “facilitated telehealth” model where medical professionals visit patients’ homes to help them get set up for telehealth visits. 4. Create a smoother patient financial experience As older patients become newly eligible for Medicare, many are unclear about their coverage status. To take the burden off the patient, providers should consider a tool such as Coverage Discovery, which allows staff to find MBI numbers quickly. This often proves helpful, particularly for new Medicare beneficiaries who may not have received their MBI card yet. A way to ease the stress of payments is to offer more transparent pricing so patients know what to expect as they start their healthcare journey. Experian Health’s Patient Financial Advisor gives a breakdown of their bill and payment options, helping them feel financially confident and more in control of their ability to pay – resulting in fewer collections issues. As older patients become more accustomed to paying for other everyday items through their smartphones or laptops, online patient payment solutions will become less foreign and more convenient, allowing them to manage medical payments in a time and place that suits them. It’s never been more important to help older patients stay connected, access care and feel supported during their healthcare journey. Contact us to explore how Experian Health’s solutions can help you close the digital divide.
From airlines to cafés to car manufacturers, businesses across America are scrambling to respond to the challenge of COVID-19. In healthcare, services are being put on pause to protect staff and patients on the pandemic’s front line, leaving health systems to contend with gaps in reimbursements and exhausted cash flows. The problem lies in the sheer number of human touchpoints involved in the typical patient experience: scheduling, paperwork, waiting rooms, treatment, payment…all that in-person interaction just isn’t realistic in the current climate. Digital and mobile technology could be the answer. While digital communication platforms have been growing steadily over the last decade, they’re now a life raft for many providers as COVID-19 forces much of the patient journey online. Megan Zweig, director of research and marketing at Rock Health, says investments in virtual care have already exceeded $3 billion this year: \"Without COVID, the story would have continued from last year as this was a healthy, growing space with a lot of momentum behind it. That momentum has turned into incredible urgency and demand for communication, testing, monitoring, care – all of those things done at a distance.\" This trajectory will likely continue beyond the immediate crisis, as providers prepare for a possible second wave later in the year and patients become accustomed to remote and mobile options. Providers that take advantage of these digital solutions now will be better positioned to optimize the patient journey in a post-COVID world. What could the digital patient journey look like beyond COVID-19? A digital healthcare experience can offer patients more convenience and flexibility while protecting revenue for providers, in the following ways: Scheduling appointments when it suits The first bump in the road for many patients is scheduling their appointment. With many in lockdown juggling home-schooling and home-working, it’s not always convenient to call during office hours. A patient scheduling platform lets the patient book their appointment whenever suits, using the channel they prefer. Before the pandemic, Benefis Health System found 50% of patients chose to book after hours, including for urgent care. We can expect this to increase as even more patients are nudged online. As the threat of COVID subsides, a massive influx of patients will also want to reschedule postponed visits. Automated patient scheduling will reduce the pressure on call centers and offer a more efficient consumer experience. Reducing registration gridlock with automation Patient access is often rife with avoidable stress – queues, unnecessary forms and manual data entry, resulting in costly errors and repeated work. Instead, providers can streamline the process by allowing pre-registration tasks to be completed online, and automating patient access with a mobile intake experience. Completing as many tasks as possible outside of the provider’s office will help minimize face-to-face contact, keeping everyone safe. Opening up access to telehealth There’s no getting around the fact that most care needs to be delivered in person. Telemedicine offers an effective way for patients to seek care from the safety of their own home. Video calls can be used for general consultations, remote monitoring of patients with respiratory conditions, and even supporting patients with chronic conditions to adhere to care plans. As the government allocates $20 million to support access to telemedicine in response to COVID-19, up to 54% of patient encounters are expected to take place remotely in the near future. Many of these patients will choose to stick with telemedicine, even when in-person options return. [Remember to check out our free COVID-19 Resource Center, where you can get free access to telehealth payer policy alerts to help avoid payment denials and delays.] Making contactless payment the easy option Contactless payment through apps such as Apple Pay and Venmo are gaining popularity as consumers try to avoid exchanging cash and cards. But can it be used in hospitals? In short, yes. Not only does Experian Health’s Patient Financial Advisor offer patients a way to make secure – and socially distanced – payments, it allows providers to give a breakdown of estimated costs using real-time information. Patients get updates on their mobile or through their patient portal. These digital alternatives not only offer a more convenient patient experience, they can also allow providers to collect payments faster and in full. Contact us to find out how digital health solutions can help your organization adapt to the new normal, and provide a better patient experience now and beyond COVID-19.
Imagine being able to offer your patients a financial experience that doesn’t stress them out. That makes patient billing quick and simple. That knocks off a few minutes from each patient registration. And that even boosts your revenue. These are just some of the benefits attendees at last week’s Cerner Health Conference were considering as they discussed opportunities for faster innovation, smarter working and transformation in the future of healthcare technology. When it comes to working smarter, attendees seemed to agree that one aspect of the healthcare experience comes out top for providers and patients alike: the cost of care. This is especially true because patients are increasingly responsible for paying their healthcare costs. And since the way services are reimbursed is constantly changing, patients are often left in the dark about how much they’ll have to pay, or how they’ll be able to afford it. Patients are struggling under the weight of financial burden We know this can have serious implications for their physical, emotional and financial health. A recent survey by the Nationwide Retirement Institute showed that as many as one in three patients aged 25-45 are delaying medical care because they’re worried about the cost, instead keeping their fingers crossed and hoping that the issue will disappear by itself. A third shop around for better prescription prices, with many not taking their meds as often as instructed in order to save money. More than half of patients wouldn’t be able to afford an unexpected bill over $1000, while a staggering 530,000 families are bankrupted by medical costs every year. Healthcare providers often end up bearing the burden of uncompensated care, or waste valuable time and resources working to uncover missing or undisclosed coverage. Either way, all this wrangling for payment has a major impact on the organization’s bottom line as well as the patient financial experience. To tackle some of these challenges, we’ve teamed up with Cerner® to support healthcare organizations to provide more compassionate and convenient billing practices. At last week’s conference, we launched the Cerner Consumer Financial Engagement suite, a newly embedded experience within Cerner’s Consumer Framework that will optimize the billing process for both patients and providers, powered by Experian® data. 3 ways the Cerner Consumer Financial Engagement suite can optimize your patient collections One of the biggest pain points for patients when it comes to managing their healthcare bills online is needing to switch between different systems for different administrative tasks. This new partnership will let patients who use the Cerner Consumer Framework access and manage all aspects of their online healthcare account in one place, creating a more convenient financial experience. The new tool will help providers improve patient collections in three ways: Smarter patient engagement When you have insights into your patients’ financial circumstances and propensity to pay, you can make more informed decisions about how to approach collections and get them on the right program from the start. Using Experian’s industry-leading datasets, providers will be able to use the Consumer Financial Engagement suite to spot patients who may benefit from alternative payment plans or financial assistance and make personalized offers that are compassionate and relevant. Giving patients a one-stop-shop for managing bills Patients are coming to expect a better experience – similar to what they might see in online retail and financial services. When it’s easy for them to settle their bills, they’re more likely to conclude their healthcare journey on a positive note and feel reassured about sticking with your organization the next time they need care. With an all-in-one patient dashboard showing current billing information, insurance deductible status, transparent cost estimates and tools to activate pay plans or financial assistance, the Cerner Consumer Framework creates a frictionless and transparent billing experience, leading to fewer late or unpaid bills and more satisfied patients. Simple and efficient collections When it comes to payments, proactive communication can help ward off some of the sticker shock that comes with unanticipated treatments and bills. The new financial engagement tool uses a simple interface that makes medical billing clear and quick for patients. When consumers aren’t put-off by the technology, they’ll be more likely to act promptly to get billing out of the way. In addition, providers will be able to add their own branding, so the patient experience is consistent from start to finish. Creating a positive patient financial experience powered by reliable data In today’s climate of increasing costs, big data and healthcare consumerism, data and analytics are now the driving force behind an efficient revenue cycle. Person-centered healthcare services that prioritize quality and patient outcomes should be a given, but the financial experience is an integral part of the total equation. This is especially true when we consider that the three biggest pain points for consumers during their healthcare journey are all related to payments! Learn more about how data-driven technology, such as the new Cerner Consumer Financial Engagement suite, can help you offer patients a better financial experience and optimize revenue at the same time.
For many patients, the unknown cost of unexpected care is a source of anxiety: two-thirds of Americans are “very worried” or “somewhat worried” about being able to cover unexpected medical bills. No wonder, when around 56% say they wouldn’t be able to afford an unexpected bill over $1,000. In cases where insurance doesn’t cover the entirety of the bill, responsibility for paying the balance falls to the patient. The lack of price transparency leads to confusion and stress for patients, and unnecessary administrative costs for providers, who are left to chase payments from growing numbers of self-pay patients. Moving towards more transparent pricing Traditionally, patient billing has been calculated at the end of the revenue cycle, after insurance adjustments have been made. In recent months, a push for meaningful price transparency is emerging as a result of consumer demands about the cost of care, pressure from governing bodies, and bipartisan support for a legislative solution to surprise billing. In response, healthcare organizations are increasingly looking to move patient billing to the front of the revenue cycle, to give consumers greater clarity about what to expect when their bill arrives. Estimating patient liability is far from simple. It calls on front office staff to make complicated calculations based on insurance benefits, charges, contractual adjustments and provider discounts. If staff are doing this manually, they may find themselves using outdated pricing lists that don’t include current insurance information, rates and discounts. So how should providers ensure their front office staff have the right tools in place to give accurate, personalized estimates for each patient? Data-driven technology can help reduce surprise billing Data-driven technology that automates, simplifies, and unifies the revenue cycle can ensure timely communication on billing between healthcare providers and insurers. This means your front-office team can base estimates on accurate, up-to-date information. To reduce the risk of errors creeping in, price transparency and collection practices should be standardized across the enterprise. A pricing transparency tool eliminates the need for manually updated price lists and removes the guesswork that often leads to mistakes. It can also include reporting features that let you track potential and actual collections, so you have greater insight into the opportunities for revenue cycle optimization. Helping patients navigate the cost of care As patients bear more out of pocket payment responsibility, they expect a better consumer experience. Creating an optimal patient collections strategy and frictionless experience is ever more important. Full transparency calls for accurate and up to date pricing to be available to patients before they receive care, along with a detailed breakdown of what their insurer will cover. When they know what the difference is, they’ll know upfront how much they’re likely to need to pay. Additionally, clear and proactive communication around the billing process can help eliminate the shock factor, improve the patient collections process, and create a better patient financial experience all round. You could provide a text-to-mobile experience that delivers a text message with a secure link to the patient’s estimated bill. Or you might integrate a price transparency tool into your patient portal or mobile app, that lets patients see a personalized cost breakdown based on real-time pricing and benefit information, alongside methods for secure payment. A price transparency tool can also help you gather insights into a patient’s financial situation and propensity to pay, so you can optimize your collection strategies from the start and get them onto the right program. El Camino Hospital in California set an organizational objective to improve price transparency. Terri Manifesto, Senior Director (Revenue Cycle) says: “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?” Working with a partner such as Experian Health lets you combine industry-leading technical expertise and payment tools with your own knowledge of your patients, so you can create the best payment experience for your consumers. Using data-driven technology, you can work to eliminate the pain of surprise bills and promote price transparency, resulting in greater revenue opportunities and customer loyalty.
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
The burden of healthcare expenses on patients is a growing problem for hospitals and patients alike. Hospitals are losing about $7.5 billion in out-of-pocket medical expenses that go uncollected every year. And collecting patient balances has become more difficult largely because patients are struggling to keep up with rising medical costs. Insurance reforms that have produced higher copays, among other things, are putting a greater financial burden on patients. They are now expected to cover about 30 percent of medical treatment costs, but many cannot afford it. In fact, high medical expenses factor into two-thirds of bankruptcies. This means that as more patients struggle to pay for healthcare, the amount of bad debt hospitals have is rising. In a survey of 100 hospital executives, 36 percent reported that their systems had $10 million or more in bad debt. And their prospects for recovering that money are grim. The issue is that many healthcare networks don’t have the technology to handle their complex collections challenges. Martin Health System was seeking a solution to automate its collections processes for self-pay revenue. Based in Florida, the healthcare network has three hospitals and numerous outpatient clinics, as well as an emergency center. That translates to a lot of patient accounts to evaluate. Martin Health needed healthcare collection software. Optimizing healthcare collections Hospitals need to be able to analyze their records to determine which patients are most likely to pay. The right software makes that process more efficient and effective so healthcare organizations can improve their collections outcomes. Martin Health System had already optimized its registration and authorization phases but system leaders felt that it could further enhance collections efforts with an automated solution. In 2016, the network implemented Experian Health’s Collections Optimization Manager. The top priorities were segmentation, identifying charity cases, scrubbing for Medicaid opportunities, and better collection agency monitoring and management. The self-pay receivables management solution automates many aspects of healthcare collections using data analytics. Martin Health was able to optimize its collections efforts by determining how to allocate resources more appropriately and place accounts with the group best suited to collect for each account. To create a more compassionate experience, the software culls through patient data to screen accounts for bankruptcy, Medicaid and charity eligibility, patient expiration, and more, to remove the accounts that shouldn’t go to collections. Then it segments the data based on priority and treatment strategies and transfers those segments to the appropriate in-house collections department or agency. The software also continuously monitors accounts for changes in patients’ ability to pay, which is no small feature. According to the aforementioned survey of hospital executives, almost one-fifth of hospitals do not re-check patient eligibility for insurance. And even worse, one-fifth of hospitals lack any process or a third-party partner to recover bad debt. This one function alone could significantly improve hospitals’ collections efforts. Martin Health System accomplished its goal of better agency monitoring through an overview of collections progress that informed business decisions. Throughout its evaluation process, the Collections Optimization Manager provides performance reports in a real-time dashboard. And the service comes with support from revenue cycle consultants who review the data. They advised Martin Health on optimal collection strategies and suggested opportunities for improvement. Ultimately, Martin Health System enhanced its collection efforts while reducing the cost to collect. The healthcare organization also found new areas to increase collections performance. In just eight months, the healthcare organization transformed its collections performance. Having a better handle on its self-pay receivables boosted Martin Health’s overall receivables by more than $4 million in just six months. That included increasing collections by $3.1 million, and finding $975,000 in Medicaid coverage. It accomplished all of these goals by putting the right healthcare debt collection software in place. Read Martin Health’s success story here or schedule a demo to learn more.
Patients are paying significantly more for healthcare these days. The typical patient spent $10,739 in 2017, compared to just $355 in 1970. And the percentage of people with private insurance enrolled in high-deductible plans continues to grow, reaching about 47 percent in 2018. More than ever, patients are demanding to know upfront how much they will be paying for the services they need. Saratoga Hospital, an organization of 450 physicians and other medical professionals in Saratoga Springs, New York, was like many hospitals around the country. It was struggling to give accurate estimates for patient responsibilities. Wading through the many insurance plans and rules associated with them to figure out what is covered and how much can be a confusing and time-consuming task for hospital staffers. The sheer volume of information, various medical billing codes, and more hampered efforts to provide transparent estimates at Saratoga Hospital. To ensure patients wouldn’t be hit with costly surprise bills later, the hospital first needed to know how much patient insurance would cover for each service provided. In 2016, Saratoga Hospital began using Experian Health’s Patient Estimates, a web-based pricing transparency tool for hospitals, medical facilities, and physicians that tells patients the cost of services at a particular healthcare organization. For example, the tool combines all related charges to estimate an accurate bill for a patient\'s appointment, which might include blood tests, medicines, facility fees, and the physician\'s charge. In addition, information such as deductibles, co-pay, and co-insurance are calculated into the tool, as are financial assistance policies for patients without insurance, including discounts for prompt payments, state-mandated discounts, and payment plans. Using all of these variables makes estimating payments much easier, and it produces greater accuracy. By training its preregistration department to use the Patient Estimates tool, Saratoga Hospital could accurately estimate authorized services for patients at the point of service (or even before), streamlining price transparency requests. This proactive approach engages patients because it keeps them informed of their responsibilities and improves their overall experience and satisfaction. Addressing this aspect of medical care is essential, considering that 85 percent of adult patients are concerned with their medical costs. Saratoga Hospital staff quickly found that patients embraced the transparency because it helped them understand their financial responsibility for receiving care before stepping into the hospital. This helped them make quicker, more informed decisions. The hospital\'s staff, equipped with a more comprehensive knowledge of what patient insurance was authorized to handle, was also more confident in requesting payments for services before they were administered. The numbers at Saratoga Hospital speak for themselves: Cash collections increased by 400 percent from 2015 to 2018. As the demand for price shopping continues to grow among health consumers, price estimates can be incorporated into an online service that creates personalized estimates. At every turn, greater transparency and efficiency in the payment process benefited patients and Saratoga Hospital alike. It provided a boost and highlighted the importance to the hospital\'s preregistration department, giving staffers the necessary training to use and maintain the Patient Estimates tool properly. And implementing the tool also led to improved quality assurance, an increase of refunds, and more efficient handling of canceled appointments. To learn more about Saratoga Hospital’s experience with price transparency, click here to watch a quick video about its success and to download the case study.
Healthcare consumerism, which describes the ability of patients to shop around for the best value of care, has affected every aspect of the industry. Keeping up with those changes has challenged most institutions as patients become more savvy about healthcare costs and their choices. But the freedom for patients to choose is only one side of the coin. The other is wrought with financial pain points that come with making the traditional billing model fit the new healthcare consumerism. For instance, organizations have to give patients precise cost estimates, but when patients change insurance coverage or companies change their policies and practices, providers struggle to keep those estimates accurate. And patients who are hit with unexpected costs after they’ve received treatment are less likely to be able pay their bills. Hospitals and providers suffer from uncollected bills, which is compounded by claims denials. Fortunately, the idea of healthcare consumerism inherently provides the solution to the pain. Emulating consumerism that\'s present in other industries, such as retail, means offering accurate and transparent pricing, eliminating uncertainty, and offering patients convenient and comprehensive financial options. Like other industries, healthcare already has a wealth of IT tools to make that possible. Headaches for patients and providers Simplifying financial pain points requires one significant change — hospitals and providers must deliver clear, simple information about what factors into their pricing. The first step is ensuring your system can keep up with the constantly changing details of insurance policies, supplier contracts, and everything else that affects those costs. An automated IT solution can collect up-to-date insurance data, claims history, a patient’s financial situation, your organization’s price, and more before generating an estimate. When this data changes, estimates are no longer accurate, which is why healthcare pricing is so complicated. Therefore, tracking them and updating your system automatically can make it easier. Most of the industry already uses analytics to some degree. Combined with automated financial data-gathering tools, those analytics can help organizations identify patients who are financially at risk and might qualify for additional funding options. Along with clear and accurate estimates, patients highly value a provider that cares enough to offer affordable financing options. Alleviating those pain points Keeping up with policy and other financial changes as quickly as they occur makes healthcare consumerism as beneficial for hospitals and providers as it is for patients. For example, Rocky Mountain Cancer Centers was able to reduce claims denials by 27 percent after implementing payer alerts and patient estimate solutions. The same strategy helped the College of Medicine at Baylor University collect nearly $4.2 million in underpaid contracts, which it would have missed otherwise. Both organizations have also significantly boosted patient satisfaction with their financial processes, which has led to more positive experiences and reviews. You can also alleviate financial pain points for patients and your organization by seeing healthcare consumerism as an opportunity instead of a burden. Patients demand the same level of cost transparency and certainty from every other industry. Healthcare organizations now have the incentive (and the means) to prove that they can offer the same level of service.
