Most industries embrace the motto "the customer is king." They are acutely aware their success is driven by it. While the complexity of the healthcare business model has made it challenging for provider organizations to adopt such an ethos, the recent rise of consumerism in the industry necessitates that providers prioritize the patient experience if they are to keep their patients happy and their bottom line healthy -- especially when it comes to billing and collections.
In a March 11 webinar, sponsored by Cedar, a patient payment and engagement platform, and hosted by Becker's Hospital Review, Florian Otto, MD, PhD, co-founder and CEO of Cedar, noted that the expectations of the healthcare consumer are shaped by innovation in other industries since "the same patient that visits your entity is also shopping on Amazon or watching Netflix." Consumers expect healthcare to evolve and deliver similar convenience and efficiency.
The biggest drivers of healthcare consumerism over the last decade include the continuously rising cost of care and the proliferation of consumer technology, such as smartphones. The rising cost of care has led to increased enrollment in high-deductible health plans. Consumers are now one of the nation's largest payers and are increasingly looking to make more informed decisions about how and where they receive care. And, with a February 2018 Pew Research Center report showing nearly 80 percent of Americans now owning a smartphone, providers should expect the demand for digital healthcare to continue increasing.
"It is also a common misconception that patients do not want to pay their medical bills. Most do want to pay," Mr. Otto said. "But the process is so complicated and cumbersome, many do not end up paying."
Thus, the current system is not working for patients or providers. Patients become frustrated with the billing process or confused by the bills, and when they do not pay, they suffer financial repercussions (i.e. low credit scores). This leads to low patient satisfaction. Patients often take to Yelp or other websites to express their frustration.
For providers, patient collections become a difficult and expensive endeavor. They also face bad debt from non-payments and may even suffer collateral damage from negative word-of-mouth or reviews.
"We need to be patient-centric," Mr. Otto said. "We need to do what helps a patient reduce stress when [they receive] a bill, making it transparent. We need to be where the patient is, and last but not least, we need to have consumer-friendly technologies."
Strategies for making the billing process more consumer-centric
Raj Mehra, head of strategy and operations, and Tiffany Jackson, director of patient and user success at Cedar, laid out three strategies healthcare organizations can employ to ensure they are putting the patient first as they design billing processes.
1. Understand the entire patient journey. It is important for providers to acknowledge the entire spectrum of care, paying close attention to pain points, Ms. Jackson said. The billing experience is often the final point of contact between the patient and provider, so it is critical to make a lasting positive impression. Complex bills, complicated jargon and confusing insurance breakdowns are some of the pain points that can cause patient satisfaction to drop.
"Throughout my many years of providing support and guidance to patients across the country, I've heard countless times 'my service was excellent, but the billing experience was not on the same level," Ms. Jackson said.
She suggested providers can better understand patient financial experience by thinking about what they value as consumers. Then, after identifying pain points, leaders can determine a path to optimization for each point.
2. Digitize and personalize the patient experience. The lack of self-service options and patient-centric technology in healthcare can frustrate patients, especially since they're used to encountering that technology in other industries, Mr. Mehra said.
Starbucks, for example, uses machine learning to look at engagement patterns and offers consumers incentives and discounts based on those patterns. Similarly, Amazon looks at previous purchase behaviors and searches to adapt each experience to the individual consumer.
"In healthcare, we can do something similar," Mr. Mehra said. "Each patient has a different experience in mind for how they want to interface with the healthcare system. Some patients may like to receive emails and interface through their desktop. Others may use text messages. Some patients may need larger fonts and messaging that eludes to payment plans."
Mr. Mehra said providers should take a look at their current process to determine if it matches up with other industries. They can also consider partnering with a third party to implement a customized technology solution and conduct a pilot program to see if it works well for their organization.
3. Provide convenient, on-demand support. Patients want answers to their questions as soon as possible, and technology can help deliver these answers in a more timely fashion. Tools such as live chat provide immediate support, with a level of human interaction patients desire.
Ms. Jackson suggested that providers need to listen to their patients regarding their preferred methods of communication and support. Research on-demand support innovation in other industries and consider investing in real-time support technology to better meet patients’ needs.
Putting winning strategies to practice: Maimonides Medical Center
Cedar worked with New York City-based Maimonides Medical Center, a $2 billion academic medical center, to improve its billing processes by modernizing its largely paper-based billing system.
Cedar helped Maimonides identify processes that could be automated with the Cedar patient payment and engagement platform. They also worked side by side with Maimonides to train the staff and support team. The pilot program yielded results within three months and was subsequently rolled out across the medical center.
Post-implementation, Maimonides saw a 97 percent patient satisfaction rate as well as a 75 percent increase in collections. Additionally, 50 percent of patients engaged with the technology without using the call center, suggesting they were able to easily understand the digital interface.
Looking ahead: The sky's the limit
In terms of consumer experience, healthcare is where airlines were a decade ago. Today, airlines work to improve the consumer experience before and after the flight, shifting to mobile and app-based consumer engagement, said Mr. Otto; however, the experience on the actual flight has not changed much.
In healthcare, it's the opposite: Clinical care delivery has made huge progress, while the experience before and after receiving care has remained stagnant.
"After discharge, the billing and transparency nightmare begins," Mr. Otto said. "Satisfaction drops and confusion increases, making it overall a pretty poor experience. We definitely want to get healthcare where the airlines are now on consumer engagement before and after the point of service."
The potential for improvement in the end-to-end patient experience is not so far off if providers continue to optimize for patient needs. Healthcare's 'new boss' is standing by.
To learn more about Cedar, click here, and view the full webinar here.