More than ever, patients expect hospitals and health systems to provide consumer-centric tools that improve their care journey.
Amid this trend, an article written in April 2018 by Elisabeth Rosenthal, journalist and former emergency department physician, outlines the "nine [financial] rights every patient should demand." University Hospitals in Cleveland took inspiration from the article in implementing its own patient financial bill of rights, which aims to provide patients with assurances as far as what they can expect out of their financial experience at the health system.
Kathy LeBrew, chief revenue cycle officer at UH, said the concepts in Ms. Rosenthal's article makes sense with healthcare's move toward consumerism, and align with UH's focus on improving patient/family access, transparency, communication and experience.
UH's patient financial bill of rights has 10 tenets, according to Ms. LeBrew:
The right to:
- An itemized and accurate bill in plain language that patients can understand
- Never receive a surprise out-of-network bill
- Accurate information about the patient's insurance plan's provider network
- A stable network
- Be informed of conflicts of interest
- Be informed in advance about facility fees
- Be informed of lower-cost options
- Be assured that a disputed bill will not be sent to a collection agency
- See a price list for elective procedures
- Patient's right to guaranteed appointment access at the right time, the right place and with the right person
Here, Ms. LeBrew discusses UH's patient financial bill of rights, the goals behind them, where the health system is in the implementation process and what other healthcare organizations should consider when trying to create their own patient financial bill of rights.
Editor's note: Responses were lightly edited for length and clarity.
Question: What prompted UH to formally implement a patient financial bill of rights?
Kathy LeBrew: Many of these tenets have been part of our internal principles focused on high quality, low cost business care that embraces continuous process improvement as a standard and an intense focus on consumerism that translates to an exceptional patient centric experience every time. In doing this, we aspire to provide convenient access, transparency, advanced communication and personalized communication and service to our patients and families. As part of financial services, we work with the patient to help simplify the billing process and ensure they understand their insurance plan benefits, out-of-pocket liability and options for their elective services. [However], as it relates to the Patient Financial Bill of Rights, the tenets are in different stages of maturity.
With the completion of our system integration project known as ONE UH, we launched the PFBR [patient financial bill of rights] program this year to advocate for the patient and formalize our service commitments. We are working to publish our standards and service level agreements as continue to advance the program. One UH has enabled standard capabilities to achieve some of the tenets by standardizing our technology.
For example, the first tenet is the right to an itemized and accurate bill in plain language. Prior to ONE UH, our health system used different financial systems and data structures, causing variation in our statement formats and language. Patients receiving services from multiple locations could get different bill formats, different bill language that was confusing to them. By October, we will have largely standardized our clinical and business solutions (with some exceptions) that support our ability to achieve the consistency and dependability inferred by the tenets.
Q: What will implementation of the patient financial bill of rights look like?
KL: These [tenets] are all in the process [of being implemented]. The evolution is not sequential. There are different strategies that are taking place to fully activate these services as they are written. Framework, service delivery, engagement, technology and consumer focus changes our need to synchronize how we interact with patients, [but] from a business perspective, [the tenets] will always be part of an ongoing process.
An important step in our progression involves identifying each opportunity to effectively communicate the PFBR to patient's either, online and in-person and in turn ask for their input on what would constitute an important business warranty/tenet. I think patients could interpret these in different ways.
While these tenets have different stages of readiness, the need for to further define their meaning will continue as our customer's needs and desires continue to change.
We are working closely with our marketing department on socializing these tenets in the coming months.
Q: What is the overall goal with this implementation?
KL: Really the overall goal is, as caregivers, to ensure our patients, families, providers and our workforce understand that the business service quality, consistency and convenience we provide to the patient is as important as the clinical service.
From the patient experience perspective, we take very seriously the role that revenue cycle plays in shaping the experience. We are typically the first contact with our patients prior to arrival and the final experience through the billing process. Our goal is to surpass the expectations of our patients and customers and create long lasting relationships with our care, and business teams.
Q: What is your advice for other hospitals and health systems looking to implement a patient financial bill of rights?
KL: Advocate for your patient and families by engaging them in a voice of a customer activity along with your care teams. I think that's imperative to understand what's important to them and to translate it into your services. We have a patient/family advisory council that we engage to understand these tenets and what it means and why it's important to them. Understanding each patient's journey and what is important to them will help to improve quality, service and value.
Know your numbers and your metrics and how impactful they are to the patient experience, use them to make important changes that results in timely, consistent and personalized service to your patients. Educate your teams constantly and continue to cultivate your culture through advocacy.
Look to every function and service to ensure there is the highest form of quality, simplicity and business transparency.
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