The patient experience and the financial health of a hospital or health system are more closely connected than ever before as the industry makes the shift toward value-based payment systems and patients shoulder more medical costs.
This content is sponsored by Zotec Partners
Providing a positive patient experience is a top priority for hospital and health system executives. Many healthcare organizations are laser-focused on improving clinical care to help ensure patients are satisfied with their visit. However, the patient experience is affected by much more than clinical care.
A hospital or health system could see patient satisfaction scores suffer if a good clinical encounter is not supported by a positive financial experience.
The patient financial experience is vital because even a patient who is pleased with their clinical visit could change their mind about the encounter once the bill arrives if it includes unexpected charges. This could make it more difficult for the hospital or health system to collect payment, especially as patients continue to see their insurance deductibles rise.
The percentage of patients with high-deductible health plans continues to increase. In fact, the number of Americans age 18 to 64 with a high-deductible health plan increased from 26.3 percent in 2011 to 39.3 percent in 2016, according to a report from the CDC's National Center for Health Statistics. Patients are paying more out of pocket for the medical care they receive, and they are demanding a better financial experience. Meeting this demand is in the best interest of provider organizations, because although patients are enrolling in health plans that require them to pay more out of pocket for their care, it is ultimately up to providers to collect that payment.
A 2014 survey of 500 patients highlights the link between the patient billing experience and a provider organization's financial health. The survey found 74 percent of patients who positively rated their billing experience paid their bills in full, while only 33 percent of patients who were less than satisfied with their billing experience paid in full.
Providing a great consumer experience is a challenge in every industry; healthcare is no exception. Fortunately, there are several strategies hospitals and health systems can employ to help meet patients' expectations regarding billing and payment processes.
Engage patients early on in the process
In today's healthcare environment, it is essential for provider organizations to ensure patients know their financial responsibilities, according to Carrie Moneymaker, vice president of solution design at Zotec Partners, a healthcare revenue cycle management services provider.
"Patients need to be engaged very early in the process regarding the financial aspect of their care, not just in the clinical aspect," Ms. Moneymaker said.
Although most patients want to be told in advance how much their medical care will cost out of pocket, few providers offer pre-treatment cost estimates. When healthcare organizations fail to provide this information, they often receive complaints from patients who are upset about unexpected charges. Not only does this lead to frustrated patients, but it also threatens the financial sustainability of the healthcare organization. Patients who are unaware of how much their healthcare services cost may be financially unprepared to pay their medical bills.
However, by informing patients of any out-of-pocket costs they may owe, hospitals and health systems not only increase the likelihood that patients pay their bills but also improve the patient experience.
To help ensure correct out-of-pocket cost information is provided to the patient, hospitals and health systems should always verify the patient's insurance before care is provided. Most hospitals and health systems use technology solutions to help them do this. For example, many are using Zotec Partners' TOS portal to estimate payments and insurance eligibility for patients.
Once the provider organization establishes what the patient owes, it is important to help the patient understand how he or she can meet those financial obligations.
"If you engage patients early on, you can set expectations and you can set up payment plans and prompt payment discounts," Ms. Moneymaker said. "You really need to get in early in that whole cycle. You can't wait until the claim is adjudicated."
In addition to setting patient expectations regarding payment obligations, it is vital in today's healthcare environment for hospitals and health systems to push for point-of-service payments to reduce bad debt from patients with increasingly high deductibles.
According to an analysis of 400,000 claims by The Advisory Board, the higher a patient's deductible, the less likely they are to pay what they owe, irrespective of their income level. The analysis found 68 percent of patients with a deductible of less than $1,000 were likely to pay at least a portion of what they owed compared to just 36 percent of those with deductibles of more than $5,000.
Empowering patients to understand their bills and what they owe so they're more willing to pay is important both to a provider organization's financial health and to the patient experience.
"When you establish that credibility with the patient … they have confidence when they receive a bill that it's valid and trustworthy," Ms. Moneymaker said.
Follow up with patients in a timely manner
Although provider organizations should attempt to collect from the patient at the point of service, they should also follow up with the patient in a timely manner if a balance is owed.
Ms. Moneymaker said many healthcare organizations wait 60 days or longer after a patient's visit to send out a bill. This can lead to negative financial consequences for both the provider organization and the patient, as the likelihood of a patient paying what he or she owes diminishes over time.
Instead of waiting weeks or months, aftercare is provided to contact patients, hospitals and health systems should strive to connect with patients as soon as a balance is owed. They should also ensure patients understand the bill they receive.
Healthcare billing processes are complex, and it is important for hospitals and health systems to provide patients with clear and concise billing statements. Many healthcare organizations across the nation have teamed up with Zotec Partners to help simplify the patient financial experience.
When patients owe a balance, Zotec Partners helps engage the patient in the process. "We send them a text, if they accept texts, so they can log on to a secure portal and look at their balance, print their statement or set up a payment plan," Ms. Moneymaker said. If patients have questions about their account, they have 24/7 access to Zotec Partners' interactive voice response system or they can speak with a patient representative during business hours.
Offer patients multiple ways to pay
If hospitals and health systems are going to remain solvent in times of higher patient financial responsibility, they must provide patients with a streamlined billing and payment process. One way provider organizations can improve the process is by offering patients multiple ways to pay a bill.
In an effort to make paying for medical care more manageable, many hospitals and health systems utilize Zotec Partners' tools to give patients the flexibility to choose a payment method. Zotec Partners allows patients to submit payments online, by text message, through an interactive voice response system or by talking to a customer service representative. This helps ensure all patients have a convenient way to pay their medical bills.
Offering a variety of payment channels is important because not all patients have the same payment preferences, and it may be necessary for healthcare providers to utilize several different channels, such as a combination of text messages and phone calls, before the patient pays his or her balance in full. To determine which payment options are most effective and used most often, many healthcare organizations deploy Zotec Partners' CZAR analytics and reporting technology to gain a better understanding of how patients are paying, according to Ms. Moneymaker.
"CZAR offers full transparency into our client's revenue cycle. They can log in 24/7 to access and track key performance indicators. We can also show them very clearly and quickly how much has gone to patient balance in a period of time, how much was collected and how it was collected," Ms. Moneymaker said.
Conclusion
Patients are responsible for larger portions of their medical expenses than ever before. Hospitals and health systems must find ways to offer more cost transparency and simplify payment and billing processes for patients to ensure they are paid appropriately and in a timely manner for services provided. Taking steps to transform the revenue cycle to make it more patient-friendly will not only help ensure provider organizations get paid, but it will also help improve the patient experience.