By Heather Grover, Vice President, Product Management, Experian Health
Twitter:Â @Experian_Health
The figures painting the picture of the nation’s patient medical debt crisis are astounding. Consumers are struggling to pay for care and that makes the media headlines, understandably so. More than 50 percent of debt collection actions in the U.S. contained medical debts and these debts were responsible for half the bankruptcy filings, according to the Kaiser Family Foundation. Unfortunately, there isn’t as much attention paid to the provider perspective on the challenges to collect revenue and be financially solvent. A recent Moody’s Investor Services report showed that hospitals found themselves in 2017 more cash-strapped than at any time since the 2008 financial crisis. Profits dropped for non-profit and public hospitals as well.
While there are a myriad of factors that contribute to the medical debt ecosystem with both providers and consumers feeling the sting of unpaid bills, one important quotient is that most consumers do want to pay – but need more choice and control as to how and when they can cover costs. While it may take some time and investment, providers can benefit greatly by evolving to meet these new consumer demands.
Financial empathy and care is just as important as the clinical side
Today’s healthcare consumers are approaching their healthcare needs with retail-like shopping behavior and want superior customer service, which includes the financial and administrative sides of their experience. As healthcare organizations try to increase collections from their customers, they should look at the unique aspects of their customers’ situation and optimize the revenue cycle with data-driven technology and customer engagement solutions like patient estimates and self-service portals. This provides consumers 24/7 information access and a better understanding of their likely obligation giving them more options and control, thus improving satisfaction.
The fiscal touchpoints throughout the consumer healthcare journey are indeed causing healthcare customers the most pain; according to an Experian Health national study, among all the activities during a consumer’s healthcare experience—from acquiring health insurance to making appointments with providers to receiving treatment—the top challenges relate to money matters. Whether its confusion about what their health insurance covers, or not understanding medical bills, consumers’ biggest dissatisfaction centers on the complex process of understanding costs and paying for their care.
Healthcare customers want to know up front what they will owe for procedures so they can budget accordingly. Knowing that consumers have several monthly payment obligations (such as rent or mortgage payments, car payments, etc.), seeking payment for healthcare procedures after care can reduce the likelihood of securing payment. That is why, providing accurate, up-front estimates is a necessity now more than ever. Using automated technology that monitors claims data, real-time eligibility and benefits information, payer contracts, and charge description master information ensures payers are fully meeting their obligations, while allowing for accurate price estimates so consumers know their fees. This can be a key first step to assisting the consumer – showing compassion and support for what lies ahead in their journey.
How providers can use and benefit from data along the continuum of care
Once a consumer understands what their cost for care will be, and in advance of a customer’s procedure, providers can determine a customer’s propensity to pay, helping them to identify the best financial pathway such as a payment plan for each customer. Additionally, healthcare organizations should provide customers with direct access to their provider and financial profile, with a proactive, simple, personalized, and compassionate mobile-first experience. This will enable customers to easily activate payment plans, apply for financial assistance, estimate the cost of care, and review insurance benefits on an ongoing basis—immediately creating a better consumer experience, from the moment they begin interacting with their provider. Organizations meanwhile are able to engage the customer more fully with their fiscal responsibilities and increase the chance for on-time payments.
When healthcare organizations incorporate this type of credit and reference data into their revenue cycle workflows, they can provide additional benefits to customers in other ways. For example, reference data from a credit bureau can assign a Unique Patient Identifier to help create a complete, longitudinal patient record across an enterprise and continuum of care. This helps customers receive more personalized care that reflects their medical and pharmaceutical history.
Issues can often be tackled best with the village approach. Providers want to provide an all-around seamless and caring experience to their healthcare customers, while consumers want to meet their financial obligations. The solution is leveraging data and technology to arm those needing financial support and options with information and empowerment, early and often, during the healthcare journey. Consumers will feel they can make better decisions about their care—and have a better financial experience, too. Providers will gain more satisfied and loyal customers, while improving the bottom line and helping to make a dent in the nationwide debt crisis.