Five Ways to Improve Patient Self-Pay

Prince

Rising healthcare costs combined with high-deductible and consumer-driven health plans are causing patients’ out-of-pocket expenses to climb-quickly. Yet, as many executives are aware, nearly half of Americans can’t afford to pay an unexpected expense of $400 without borrowing money or selling something of value.

With annual deductibles commonly reaching $2,000 to $10,000, many patients struggle to pay their healthcare bills without some sort of financial plan or assistance. This affects not only the patient’s experience and satisfaction, but also the healthcare organization’s accounts receivable  and revenue flow. The administrative costs to chase and collect patient payments further impacts the health system’s bottom line, as does bad debt.

Consequently, it’s important to consider how a proactive approach to patient billing can help hospitals and health systems reap financial benefits while also enhancing the patient’s experience and overall satisfaction.

Improve self-pay, improve patient experience

Despite efforts to improve the billing experience, 72% of polled consumers report that their health plan and provider experiences have remained the same in the last two years-or have gotten worse. The most common patient complaints are related to communication, long wait times, staff, and billing.

With healthcare “consumerism” on the rise, patients know they have options. Many are starting to shop around for organizations that offer help navigating the financial aspects of care. In response, hospitals and health systems are finding ways to effectively collect payments from patients while promoting a positive experience.

The key is to adopt an approach that makes the billing process easier and more understandable for patients, thus increasing collections in a manner that also improves satisfaction.

Here are five ways healthcare organizations can be more proactive about patient payments:

• Start with a winning formula.

An effective approach to self-pay combines patient advocacy with the right processes and technology to maximize collections and shorten collection cycles. In many instances, an organization can estimate patient costs, verify insurance eligibility, and assess patients’ propensity to pay using data analytics and technology before they even set foot in the facility.

Some organizations maintain such tools and skillsets in-house, while others choose to work with partners that can analyze their needs, customize workflows, provide and support related technology, and fill service gaps when necessary.

     2.   Engage patients: The earlier the better.

Americans’ greatest financial concern according to Gallup is the cost of healthcare and how to pay for it. Hospitals and health systems best serve patients-and themselves-by letting patients know how much they’re going to owe as early as possible. Whenever feasible, they should try to collect 50% or more of this amount prior to service.

When patients can’t afford to pay these costs, healthcare executives should empower staff to help set up payment plans, answer questions and counsel patients on their financial options. Doing so not only increases patients’ likelihood of paying their bills, it also helps reduce their anxiety.

     3.   Never miss an opportunity to collect payments.

If patients are ready and willing to pay their bills, the facility should have staff members on-site-at every point of service-to help them. Organizations can provide scripts and coach staff so they’re able to have meaningful discussions with patients about their finances.

     4.   Take a page from Amazon’s playbook.

Retail, entertainment, banking, and many other industries have realized consumers are more likely to spend their money and pay their bills when it’s convenient for them. Why should healthcare be any different?

Most people are accustomed to making purchases and paying bills online. Healthcare executives should ensure their patients also have this ability. Offer online access to their accounts so they can make payments anytime, anywhere. Let them see how much of the bill their insurance will cover and how much remains their responsibility. Allow them to set up and make recurring payments. Make it easy and convenient to pay.

     5.   Empower patients.

There’s nothing more frustrating than having a question or complaint and not knowing where to turn for help. Hospitals and health systems should have an efficient process in place for managing patients’ financial questions and complaints over the phone-and then make sure patients are aware of it.

Contact information should be printed on billing statements, emails and available online-either on the organization’s website or portal-so patients don’t have to search for it. Hospitals and health systems should also routinely audit their financial assistance process to ensure staff are responsive and all is functioning as intended.

A recent Kaiser Family Foundation analysis predicts seniors on Medicare will spend half of their social security income on out-of-pocket health expenses by the year 2030. There’s no question having an effective self-pay program-and one that preserves patient satisfaction and loyalty-will be essential to the long-term viability of healthcare organizations. By taking a proactive approach to self-pay now, hospitals and health systems can help protect the bottom line while also safeguarding the patient experience.

Beth Prince is the director of operations, Revenue Cycle Services at Change Healthcare. She has 20+ years of experience in the Acute Care and Ambulatory Revenue Cycle arena and is currently serving as director of operations, revenue cycle outsourcing solutions.