As Payment Responsibility Rises, Consumers Expect More from their Healthcare Experience

November 1, 2017 Phil C. Solomon

The level of respect, compassion and sensitivity to healthcare consumers is increasingly being used to judge patient satisfaction regarding quality of care and is an important component of a healthcare system’s care delivery.

There is an increasing focus on encouraging individuals to be more involved in their care, which has prompted providers to deliver healthcare in a more patient-centered way. Patient-centered care is focused on adapting services around the needs of consumers. These efforts are designed to engage patients, their family members and caregivers to achieve better clinical outcomes.

Today, patients expect to receive respectful treatment, enough information to make good decisions about their care, clear and abundant communication and quality clinical outcomes. Positive patient and staff experiences lead to good health outcomes through clinical effectiveness, which drives high levels of patient satisfaction and loyalty.

The new patient-centric care model is not without its challenges. The cost of delivering healthcare is rising quickly, and the consumer must now shoulder more of the costs. The new financial demands on patients have created a conundrum. Patients are enjoying newly implemented consumer-driven healthcare, but they are now paying handily for it. A study by Black Book™ indicates that since 2015, patients have experienced a 29.4 percent increase in both deductible and maximum out-of-pocket costs.

The Savvy Healthcare Consumer

A patient’s healthcare journey is a complex one. Beginning with pre-care, treatment, and ending with a measure of patient satisfaction, the emerging concept of patient-centric healthcare has many touchpoints that can break down and cause dissatisfaction. To satisfy savvier consumers, industry experts must address the gaps in the current patient experience by focusing on the entire patient healthcare continuum, from initial patient decision-making, scheduling, registration, administrative simplification, price transparency and effective consumer payment methods.

In March 2016, the Healthcare Information and Management Systems Society (HIMSS) Revenue Cycle Improvement Task Force study, A Roadmap to The Patient Financial Experience of the Future, reported that “the growth in consumer financial responsibility has led to the expected billing and collections challenges that were known to be weak points of a patient-centric revenue cycle. Many industry experts did not consider how much more information a patient with greater financial responsibility would come to expect.”

Traditional models for accessing and sharing health insurance, financial and clinical information, and a lack of interoperability between the systems that support these models are insufficient to meet the increasing demand for real-time information and price transparency.

As consumers shoulder larger amounts of financial responsibility for their healthcare, they begin to view healthcare as a retail experience, which means:

  • They are likely to transfer their expectations as a typical retail consumer to their healthcare experience.
  • More patients are researching their healthcare options before deciding where to go for care.
  • They are leveraging technology to determine the level of care available to them.
  • They expect to have pricing and quality or patient satisfaction information at their fingertips.
  • They think they should be able to use this and other information to compare providers in the same way they might compare consumer products they would purchase online.

Providers Address Consumerism with New Payment Financial Solutions

The new era of patient consumerism demands more technology-driven financing options, engaging patients early, analyzing consumers’ propensity to pay, managing expectations and genuine cost transparency.

Black Book announced key findings from its 2017 Revenue Cycle Management surveys part of a larger study of trends in consumer satisfaction and patient experiences and payment challenges and strategies for healthcare providers.

They determined that 83 percent of surveyed providers plan to meet the rise in patient consumerism with more retail-like technology solutions and practices.

“Emerging healthcare pay trends reveal the opportunity to help patients better anticipate, manage and track the costs of their care,” said Doug Brown, Managing Partner of Black Book. “Innovative patient-friendly payment solutions that meet consumer preferences and enable fast transactions are playing a key role in this transition.”

Black Book conducted two sets of focused polls in the second and third quarters of 2017 with both patients and providers. Consumer panel surveys aimed to determine how patient responsibility for medical costs, which has shifted from employers to patients, is impacting uncollected provider revenue. Black Book found that since 2015, patients have experienced a 29.4 percent increase in both deductible and maximum out-of-pocket costs, with an average deductible for consumers at $1,820 and out-of-pocket costs rising to over $4,400. The combined surveys included 2,698 providers and a focus group of 850 healthcare consumers with high deductible health plans.

Survey findings from 1,595 physician practices, 202 hospitals and 49 health systems reveal profit margins continue to be impacted negatively by traditional collection solutions, steering 82 percent of medical providers and 92 percent of hospitals to eliminate time-intensive, error-prone, manual effort to implement back-end process and reconcile bills by the fourth quarter of 2018. With millions of dollars of unpaid medical bills, many providers are instituting new processes and technologies to recover the monies owed them.

“Employing these solutions at the front end of the revenue cycle has given patient risk to providers and the attention has turned to establishing funding mechanisms to benefit not only the hospital or physician but the consumer,” said Brown. “Patients truly are the new payers.”

Results also determined that in the first half of 2017, nearly 62 percent of medical bills were paid online and 95 percent of consumers polled would pay online if the provider’s website had the option.

Seventy-one percent of patients also reveal that mobile pay and billing alerts have improved their actual satisfaction with the provider.

Online estimation, payment plan administration and on-demand instructions support (all of which were ranked by consumers in the top five improvements providers could make to improve satisfaction) produce more cost transparency for consumers. “For providers, that brings faster posting and collection of payments without manual processing errors,” added Brown.

Guest pay (allowing spouses, family members, friends, attorneys and others to pay patient bills without accessing patient medical records) is also improving consumer satisfaction. Fifty-nine percent of consumers appreciate the convenience and simplicity of online payments without the hassles of registration and passwords.

Summary

Industry stakeholders have acknowledged the need for health plans and providers to share information with consumers in a more coordinated fashion to enable improved consumer financial activities. The seamless connection between healthcare financial and clinical systems is critical to respond to the new revenue cycle demands. Consumers expect an improved financial experience in healthcare and providers must step up to provide the healthcare services, payment systems and technology to serve patients at higher levels.

____________________

Phil C. Solomon is the publisher of Revenue Cycle News, a healthcare business information blog and serves as the Vice President of Marketing Strategy for MiraMed, a healthcare revenue cycle outsourcing company.  As an executive leader, he is responsible for creating and executing sales and marketing strategies which drive new business development and client engagement. Phil has over 25 years’ experience consulting on a broad range of healthcare initiatives for clinical and revenue cycle performance improvement.  He has worked with industry’s largest health systems developing executable strategies for revenue enhancement, expense reduction, and clinical transformation. He can be reached at philcsolomon@gmail.com

The post As Payment Responsibility Rises, Consumers Expect More from their Healthcare Experience appeared first on REVENUE CYCLE NEWS.

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