Improving the Patient Payment Experience

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Three Opportunities to Improve the Patient Financial Experience

Before high-deductible health plans, patients took a more laissez-faire attitude toward their healthcare bills. Beyond co-pays, they just expected their insurance company would take care of the rest. Not so today. It is estimated that patient payments now make up 35% of a provider’s revenue [1]. And that’s a problem since 40% of adults in the US say they would not be able to pay an unexpected $400 bill.[2]

$7.5 billion in patient payments goes uncollected each year. [3]

But the challenge goes deeper than just trying to collect. Since patients now owe more of their own healthcare costs, they’re demanding more: more control, more value, more information on costs, and more payment options. In short, they’re demanding a better financial experience—one that resembles a retail experience and includes excellent customer service.

In a recent survey of healthcare executives across the US, “the patient experience” was listed as one of the top two concerns, right alongside declining reimbursements.[4]

The best way to ensure optimal collections and a better patient experience are to develop a new approach to revenue cycle processes—one founded on innovation and focused on the patient. The following are three opportunities to make meaningful, long-term improvements that will optimize your bottom line.

Leverage patient data

Using a one-size-fits-all collections model is ineffective as not all patients have the same ability to pay. Providers should leverage propensity to pay analytics, as well as eligibility verification technology, to get an accurate picture of each patient’s unique financial situation and coverage.

This insight can then inform the financial conversation. Perhaps the patient is eligible for financial assistance or charity care. Sending multiple collection letters or turning these patients over to aggressive collection agencies can damage the patient-provider relationship, lower patient satisfaction scores, and harm your brand reputation. It may also result in patients putting off needed care, which can impact outcomes and payer reimbursement.

Make it easier for patients to pay

While price transparency legislation is still in the works, providers should already have a plan in place to improve transparency in their own organization. This should include patient responsibility estimation. These solutions are readily available and designed to work seamlessly with a provider’s existing systems. Patient access personnel can use these estimates to educate patients about the cost of the service, what their insurance plan covers, and what their final responsibility will be. In this way, providers can position themselves as advocates for the patient, which improves loyalty and the patient-provider relationship.

A recent survey of more than 2,000 patients revealed that 90% of patients want to pay their medical bills in full, and the same percentage want a payment plan option to help them do so.[5]

The best time to offer a payment plan is during the patient access process. Asking for payment only after the patient visit can reduce collections by 30% to 50% [6]. It’s important that the plan is customized to the patient’s unique financial situation and that costs incurred in the future can be added to the plan—including those of the patient’s family members.

Besides payment plans, providers should have a variety of payment options available. For instance, a 2017 poll by Black Book found 95% of consumers want the ability to pay their healthcare bills online. Yet providers still fall short in the area of digital payment technology [7]. Automated voice recognition for phone payments is also a convenient option patients appreciate.

Ensure Vendor Compliance

Turning collections over to an agency or early-out vendor can help hospitals and providers who don’t have in-house expertise or resources. While this can be a viable option, it is critical that those agencies understand they are acting as an extension of the hospital. The patient likely doesn’t know the person on the phone is not a hospital employee, so every encounter reflects on the hospital’s culture. An aggressive agent can harm the hospital’s reputation and reduce the likelihood of payment.

It is also essential that collection vendors abide by industry best practices to ensure compliance with service level agreements and regulatory requirements. A recent analysis by Healthfuse found that 21% of accounts placed with outsourcers were aged beyond 120 days. The same analysis found vendor non-compliance rates of more than 50% for early-out self-pay accounts. Hospitals need the ability to monitor revenue cycle processes—from reconciliation to payment integrity—to ensure they’re achieving a positive ROI on their vendor relationships.

The Bottom-Line Connection

Research shows there is a direct correlation between the patient experience and a hospital’s brand reputation and “ability to capitalize on market share.” [8] Whether providers manage their revenue cycle and collection processes internally or they outsource to vendors, they must understand the impact of the patient experience on long-term financial viability. Implementing a patient-centric payment strategy can improve patient satisfaction, reduce collection costs, lower days in A/R, and optimize the bottom line.


[1] https://www.forbes.com/sites/allbusiness/2017/06/28/what-we-can-all-do-about-rising-healthcare-costs/#6e548a182f37

[2] https://www.federalreserve.gov/publications/files/2017-report-economic-well-being-us-households-201805.pdf

[3] https://www.pymnts.com/healthcare/2019/hospital-payment-plans-medical-debt/

[4] https://www.fiercehealthcare.com/finance/reducing-costs-improving-patient-experience-top-mind-for-health-system-leaders-survey

[5] https://www.pymnts.com/healthcare/2019/hospital-payment-plans-medical-debt/

[6] https://www.medirevv.com/the-definitive-guide-to-a-winning-self-pay-strategy?hsCtaTracking=13db9946-4ff7-4288-83ad-1ff313c888d2%7C03ae6107-8d9b-409b-b430-2a5c839cc693

[7] https://www.beckersasc.com/asc-coding-billing-and-collections/12-trends-in-patient-responsibility-payments-up-29-4-since-2015.html

[8] https://www.beckershospitalreview.com/hospital-physician-relationships/patient-experience-and-quality-impacts-on-reimbursement-5-things-to-know.html

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