With more than half of U.S. adults reporting having delayed or foregone care in the past year due to cost, the financial challenges for self-pay patients and those with high deductibles are particularly acute.
During a December webinar hosted by Becker's Hospital Review and sponsored by Rectangle Health, four leaders in orthopedics discussed how cost transparency, bundled pricing, financing options and more can help address the high cost of care. Panelists were:
- Chrys Hall, Director, Enterprise Solutions, Rectangle Health
- Darren Harris, CEO, Bone and Joint Institute of Tennessee (Franklin, Tenn.)
- Kevin Joyce, CEO, Orlando (Fla.) Orthopaedic Center
- James Keil, CEO, Santa Rosa (Calif.) Orthopedics
Three key insights were:
- Communicating total costs upfront is key to helping patients plan for and afford needed care. The way providers traditionally communicate their fees, separating physician fees from facility fees and leaving it up to patients to figure out their total out-of-pocket expense, is not user-friendly. To help patients better understand and budget for the cost of care they would be responsible for, some practices are now aiming to provide comprehensive price estimates.
"Our approach with patients is to be inclusive [in our estimates] of the total episode of care," Mr. Keil said. He explained that Santa Rosa Orthopedics also helps patients figure out what portion of their care expenses are covered by worker's compensation, adding that this is the real transparency patients need, as opposed to simply having organizations publish their prices.
Other practices are going further by not only communicating the total cost of care, but also advertising slightly discounted cash-based services for patients with high-deductible health plans, for whom paying in cash may be cheaper than paying the deductible. "It's been a real benefit to us to [offer] transparent pricing, so that patients know what care is going to cost before they come into the building," Mr. Harris said.
- Transparency is necessary but not sufficient for an excellent patient financial experience. Additional approaches providers may implement to make care more affordable and convenient, which from a technology standpoint are already widely used outside healthcare, include nearly 100% approval,non-recourse financing options like Rectangle Health’s Care Now, Pay LaterSM, card-on-file transactions, self-serve online bill pay, and text-to-pay messages.
"If you're doing everything at your front desk and you're sending out paper statements and you’ve got people on the phone calling during business hours trying to collect moneyyou're not going to make it because no one's answering their phone," Mr. Joyce said.
Although having such functionalities in place has been demonstrated to improve both the patient experience and providers' bottom line, Mr. Joyce acknowledged though it is sometimes difficult to get physicians to invest in them. "Our biggest challenge is convincing our doctors to spend the extra money [while understanding] this is something that's worth it, because they sometimes look at it as something that's just overhead."
- Private orthopedic practices are typically more affordable than hospitals and health systems and should put more effort into marketing themselves. Although outpatient orthopedic practices do not have the financial and marketing muscle of larger operators, they should identify their strongest differential advantage and capitalize on it as best as they can. One way to do that is to highlight their high-quality health outcomes compared to cost. Another, more innovative way, is to highlight their customized approach and sensitivity to the patient financial experience.
"We should be telling patients that physicians are not only there to take care of your physical health, but also of your financial health," Mr. Hall concluded.