From the Metal Plans offered under the ACA to employers' tendency to seek ways to save on benefits costs, high deductible healthcare plans, and as a consequence patient financial responsibility, are on the rise. Hospitals and health systems, accustomed to negotiating with insurance companies to receive the bulk of payment for services rendered, are suddenly faced with a new payer group: consumers.
Here are 10 things to know about how consumer financial obligation affects providers' and hospitals' collection efforts and patients' ability to pay.
1. From 2011 to 2014, the number of consumer payments to healthcare providers increased 193 percent, according to the "Trends in Healthcare Payments Fifth Annual Report: 2014" from InstaMed.
2. When collections efforts fail, a fairly common occurrence, hospitals take on bad debt. Since 2000, all types of hospitals have provided more than $502 billion in uncompensated care, according to the American Hospital Association. In 2014, uncompensated care accounted for 5.3 percent of total expenses for community hospitals.
3. The majority of physician practices and provider facilities (90 percent) agree that collecting from patients before they leave the office is important to their businesses, according to "The Impact of Consumerism on Provider Revenues" report from Availity.
4. Providers are largely in agreement about the difficulty of collecting after patients leave the office: 85 percent report collecting patient financial responsibility post-visit is not a simple task, according to the Availity report.
5. Though most of the healthcare industry recognizes the importance of patient collections and the challenges it can represent, up-front collections remains an underutilized strategy. More than half of physician practices (59 percent) report collecting from patients while they are in the office. But, just 35 percent of hospitals collect at the point of service, according to the Availity report.
6. Upfront collections may not be used across the board in healthcare, but this strategy is a growing trend. Eighty-one percent of providers have invested in software and staff to support up-front payment efforts, according to the Availity report.
7. In 2014, hospitals reported just 34 percent of patients were able to pay the full amount requested at the point of service. Physician practices reported 56 percent of patients were able to provide the full amount requested during point-of-service collection efforts, according to the Availity survey.
8. Upfront discussions go a long way to make patients aware of and prepared for their financial responsibility. More than half of hospitals (52 percent) use payment estimation tools. Twenty-six percent of physician practices use payment estimators. Approximately a third of hospitals (34 percent) use online scripting for patient payment discussions, while 22 percent physician practices do the same, according to the Availity report.
9. As patient payment expectations in healthcare rise, consumer convenience becomes more important. Consumers are looking to pay with a credit card and on their mobile devices. In 2012, 81 percent of patient payments were made with a credit card, according to the InstaMed report. In 2014, 85 percent of payments were made with a credit card. The proportion of payments made on mobile devices rose from 2 percent in 2011 to 11 percent in 2014.
10. By 2017, hospitals expect to collect at least some fees upfront from 31 percent of patients, up from 15 percent of patients in 2011. Physician practices expect to collect upfront at least partial amount owed from 44 percent of patients in 2017, up from 28 percent of patients in 2011, according to the Availity report.