Tailoring financial plans based on a patient's economic circumstances can prove financially beneficial for hospitals and health systems, said James Zadoorian, PhD, managing principal at ARxChange, which designs patient financial revenue systems.
Dr. Zadoorian touts what he calls adaptive financial assistance, an approach using "enhanced analytic methods that adjust more dynamically to provider fiscal needs and patient economic diversity."
"The premise behind AFA is that patients cannot pay when financial assistance is inadequate," he said.
Data used to design adaptive financial assistance, from an ARxChange study, showed organizations financially benefit when financial assistance scenarios are more in line with each patient's economic circumstances, he said.
The study of about 785,000 insured and uninsured patient accounts between 2010 through 2017 showed an 83 percent per-account revenue increase for uninsured patients and 22 percent for the insured, with the average probability of full payment roughly doubling for the insured and quadrupling for the uninsured.
Offering patients more tailored and customized financial assistance strategies early in their care journey increases provider reimbursement expectations and reduces the effects of systemic nonpayment, particularly for uninsured patients with low to-moderate affordability who are less likely to pay in full, Dr. Zadoorian said.
More information about the adaptive financial assistance is available in this piece co-authored by Dr. Zadoorian.
If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.
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