When it comes to billing, the U.S. healthcare system generally takes a siloed approach, which can result in patients receiving multiple statements for different services or even for different elements of a single service. Patients, however, view their experience as one unified journey.
To learn how hospitals and health systems are taking a more patient-centric view to improve the patient financial experience, Becker's Hospital Review recently spoke with Maria Abernathy, Vice President of Payment Operations at Waystar.
Note: Responses have been edited for clarity.
Question: While clinical quality is always top of mind, the influence of consumerism is challenging providers to transform the financial experience, as many patients now say they worry more about the bill they will have to pay than about the quality of care they will receive. Can you share some examples of how providers are rising to that challenge?
Maria Abernathy: Piedmont Healthcare in Atlanta created an entire team devoted to the patient financial experience. This team focused on outbound patient billing communications and how the billing experience aligned with Piedmont's three-year strategic goal of increasing patient collections by $10 million.
The organization also taught team members how to have compassionate financial conversations with patients, in person at the time of their appointment. Team members inform patients on what they owe and why, which empowers patients with financial information and payment options earlier on, leading to increased engagement and ultimately making them more likely to pay.
In addition to optimized communications, Piedmont Health also rolled out retail, point-of-sale type devices so that patients felt secure making check and credit card payments at healthcare facilities. This increased patient access collections.
Q: An increasingly large percentage of provider revenue is dependent on patient financial responsibility and accelerating cash flow. How are clients balancing the need to improve the patient experience with the need to collect?
MA: When I first started working in the healthcare payment space, the focus was on large payers. Now, patients are the third-largest payer. Because of the growing importance of patients in making payments, providers must learn to communicate more effectively with patients about financial issues.
We’ve seen that self-service payment plans that meet a patient’s budget are one of the key ways that providers can offer flexibility. It’s not just payment plans, though, it’s about creating a patient-centric experience all around. This means meeting patients where they are and communicating with them via methods they prefer. It means personalizing communications to provide the right information at the right time, so that patients feel heard and understood, and more importantly, so they don’t just feel like a number. This builds trust with patients and empowers them to take charge of their financial responsibility, which leads to faster, fuller payments.
Great River Health in Iowa used to get 6,000 patient calls every month about payment plans and large balances that were due. After adopting the Waystar platform, Great River Health put in different business rules and enabled patients to extend balances out to whatever time horizon they needed. Great River Health saw a 40 percent reduction in patient calls and saw a 30 to 40 percent increase in adoption of self-service payment plans. Not everyone wants to talk about the bills they owe. Now they can set up the parameters that work for them, without having intensely personal conversations about affordability.
Q: How can hospitals and healthcare organizations do a better job of viewing patient experience through the lens of one journey versus the sum of its parts?
MA: The key is to unify the financial aspect as much as possible so that patients have one bill, one payment plan, and one financial experience across their entire encounter.
The hospitals that pair the clinical and financial experiences for patients have been the groups that have done the best job. Great River Health and Piedmont Healthcare are perfect examples of organizations that took a step back and thought about the experience from the patient's perspective. There's a trend to bring the pharmacy world into this unified patient financial experience, as well. For example, several organizations process their pharmacy payments through Waystar. If you start with the patient, that's the best way to break down silos.
As value-based care grows in our country, it will be critical to think about connecting the dots between care and cost, which is easier for providers that have a unified approach across the entirety of their revenue cycle. Providers need to prove patient outcomes and if they haven't mapped communications to outcomes, it will be much harder to collect. Value-based care will only work if we figure out consolidated billing and incorporate it into a true patient financial care platform.
Q: What are some specific tips that providers can implement that will have a positive impact on the patient experience and on patient collections?
MA: Think about the patient financial journey and map out the flows for estimates, scheduling and bills. Identify all the places where patients could receive communications that are conflicting or confusing. If patients trust that providers are sending them an accurate bill, they will be more likely to pay the first time they receive it.
The goal is to put the patient's needs first, which means greater transparency up front, better communication, and flexible, affordable options — which ultimately results in happier patients and fuller payments.