The patient payment experience is an inseparable part of the overall patient experience.
Yet, amid the fragmentation of payers, providers and technology vendors, some healthcare organizations are just now understanding its far-reaching implications.
Becker's Hospital Review recently spoke with Jim Economou, system director of patient access and pre-service center at Edward-Elmhurst Health in Naperville, Ill., and Brad Tinnermon, vice president for enterprise revenue cycle at Banner Health in Phoenix, about what their organizations are doing to place the payment experience front and center in their strategies.
Patient experience priorities for 2023 include continued digitalization and seamless, personalized care
Having access to patient-level insights that can drive improvements in the design of healthcare organizations' digital front door, as well as highlight gaps in care coordination and health outcomes, is a strategic priority for providers.
To gain access to such insights, Edward-Elmhurst is conducting interviews, surveys, patient committees and usage reports to gather patient feedback. "Patients are the ones who are utilizing our services, and if we don´t get their input and measure it, we don´t really know how well we're doing," Mr. Economou said. He added that patient feedback has important implications for physicians, too. "A physician may be familiar with what happens in their office, but they don´t see what patients have to go through to schedule appointments, get lab tests or pay their bill."
Bringing the patient payment experience becoming on par with the clinical experience
Healthcare organizations are increasingly coming to grips with the importance of the patient financial experience as a key component of the overall patient experience, specifically as it concerns cost transparency and convenience.
Edward-Elmurst is addressing this by providing upfront estimates of what patients would owe for services they are to receive at the time of appointment scheduling. The organization sends those estimates to patients digitally. "Everything is at their fingertips 24/7 and they can make the payment before the time of service, at the time of service or even afterwards," Mr. Economou said, noting that his organization's goal is to ensure that patients' financial experiences are as good as their clinical experiences. At present, the majority of Edward-Elmhurst's bill estimates are enabled for medical imaging services and for noninvasive cardiology procedures.
Banner Health shares Edward-Elmhurst's goal of putting as much self-service into patients' hands as possible. "We believe that simplifying the experience, improving transparency and creating more interaction with patients is key," Mr. Tinnermon said.
However, Mr. Tinnermon recognized that there are some elements that create friction for patients — including access, medical necessity denials and prior authorizations — and require action from providers. Banner is working with payers to smooth out those processes by leveraging payer-provider collaboration to generate correct estimates of applicable coverage, deductibles and amounts due. "[The ability to] peek into the payer system is key to ensure we're working off the right contractual terms and understanding the true out-of-pocket responsibility for a patient," he said.
Technology can be a trust-building tool between patients and health systems that also saves costs
Technological capabilities that allow hospitals and health systems to "peek into" payer data for the purpose of generating more precise bill estimates have important implications for improving patients' trust with providers. Because such transparency allows organizations to know whether a patient is likely to owe for a bill and in what amount before a service is delivered, they can in turn inform patients in a timely fashion rather than have them wait for months on end without a clue.
"We're using a package tracker methodology to show, 'Your bill is being processed and you owe nothing, so don't expect anything,' or, 'We're working with a payer and it's going to take longer than expected,'" Mr. Tinnermon explained. "Transparency is huge for people feeling comfortable with their bill."
Technologies that bring transparency to the patient payment experience also have financial benefits for organizations. By eliminating the need to pay third-party providers to "lift and shift" de-identified data that informs estimates, they enable health systems to realize savings in their revenue cycle.
"Having direct linked information at the payer level is where the future is," Mr. Tinnermon said. "If you think of any CRM type of product where the data is exposed in a central location, but then it's API'd out or connected in multiple different systems and tools — that's where we'd like to go with payers."