At Becker’s 8th Annual CEO & CFO Roundtable in Chicago in November, Simplee hosted an executive roundtable to explore different approaches health systems can take to respond to healthcare’s consumerism demand and deliver the financial experience today’s patients expect.
Patients want an Amazon-like experience, but many providers are struggling to deliver
Patients want price information to be accessible and delivered to them prior to a visit so they can understand their total costs. Often knowing their out-of-pocket cost is not enough without offering affordable paths to payment as well. The transparency tools and services that can help organizations meet consumer demands include out-of-pocket estimates prior to care, flexible payment plan options and a consolidated bill that includes the total visit cost.
Tim Bridge, Simplee’s vice president for the east region, said, “Outside of healthcare, consumers don’t buy things without knowing the price. You can make your patients better, but you don’t want to make them sick again after you send them the bill.”
Health system executives are starting to recognize the need to provide patients with an Amazon-like experience. Simplee recently commissioned a survey of executives at over 100 healthcare organizations about their top patient access priorities. Registration quality was number one, followed by preservice cost estimates and preservice patient collections.
Health system aspirations, however, often fall short of patient expectations. The CMO of a large public health system in the Southeast explained, “We try to tie patient estimates to their insurance company and provide publicly reported quality metrics on our website, but it’s not terribly interactive.”
Omni-channel approaches that combine paper and mobile optimized digital communications are important when considering the experience. Especially in rural communities where patients often utilize unlimited data plans through mobile devices over the cost of expensive desktop devices and internet.
The complexity of the insurance market also contributes to price transparency and affordability challenges. Unfortunately, some patients end up paying more for services through their insurance plan than they would if they had absolutely no insurance. It’s no surprise that patients are still confused by the financial components of the healthcare system.
The CFO of a small critical access hospital in the Southwest echoed this challenge. “All of our major employers have gone to a $5,000 deductible. If a patient needs an MRI that comes out negative and they need no further testing, the insurance company’s negotiated rate is $1,800. For patients with no insurance, we’ll do it for $550. Patients want us to bill their insurance, so they end up with an out-of-pocket bill for $1,800. They usually don’t pay us a dime. The mentality is that if you can’t pay the whole thing, why pay any of it. Yet, they could have afforded the $550 charge.”
AdventHealth has adopted technology to enhance patients’ pre-service financial experience
Like many health system leaders, Altamonte Springs, Fla.-based AdventHealth executives acknowledged their organization needed to engage patients earlier in their healthcare journey. Rather than relying on time-consuming phone calls, the organization decided to implement an automated system to address affordability issues and to increase preservice collections.
When patients are scheduled for a procedure, they receive an email reminder five days in advance and follow up one day in advance. This message includes a link that brings patients to a page that shows their out-of-pocket costs and different payment options. Patients can sign up for a payment plan immediately.
Laryssa Polika-Engle, Simplee’s director of product marketing, said, “Knowing this information up front has been a stress reliever for many patients. AdventHealth has found that 35 percent of patients click through the emails to learn about their financial obligations.”
The average patient payment at AdventHealth has been $450. The health system has increased collections by 41 percent and the number of no-shows for appointments has decreased by 8 percent. Based on these results, AdventHealth has expanded the preservice program from 10 facilities to 25. It now sends out around 10,000 estimates per month.
The effort has helped AdventHealth achieve greater patient satisfaction. According to Ms. Polika-Engle, the health system has a net promoter score of 64, which is more than double the average for healthcare organizations. The score is a measure of customer loyalty. Traditionally, providers struggle in this arena and the average net promoter score for health systems is 23.
During the conversation, Ms. Polika-Engle shared AdventHealth patient testimonials. One patient said it’s “nice to know ahead of time what the charges will be,” and another said it’s “great to have a cost estimate going in, and the ease of paying is an added benefit.”
Patient care means both clinical care and financial care
Every healthcare organization strives to deliver an excellent clinical experience. The entire patient experience can be negative, however, if individuals are angry because they don’t know the price of the procedure up front and are upset at the end because they don’t have a way to pay.
“Through our research around price transparency we’ve found that many institutions try to send their patient satisfaction surveys out before the bill arrives, so the bill doesn’t taint their results,” Ms. Polika-Engle said.
Effective patient financial engagement means providing an on-demand, retail-like experience through digital self-service, emails and text messages about bills, and payment plans that are calculated using artificial intelligence to match the patient’s ability to pay.
Simplee offers these services for the pre- and post-service phases of the patient journey. Simplee has also partnered with CareCredit, an industry leader in patient financing. According to Ms. Polika-Engle, “If an institution can only offer patients 24 months of financing, it could use CareCredit to extend financing up to 60 months. This offers an additional path to affordability to patients, because they can pay at their own pace. Healthcare providers get paid up front, while CareCredit delivers a stellar payment experience to the patient.”
For health systems that want to enhance the patient financial experience, Mr. Bridge recommended three actions:
1. Ask patients what they want. Think about patients as consumers and conduct an analysis to identify what they want from a healthcare provider.
2. Consider internal alignment. When evaluating how your organization communicates with patients, it is important to involve patient access, the IT team and the revenue cycle department. All the groups should be internally aligned.
3. Create a patient engagement plan. Look for a scalable solution that supports digital communications. When patients schedule a procedure, staff should always ask for their email address.
Conclusion
Price transparency is a term that has become ubiquitous in healthcare, but in practice very few providers offer it to patients. Leading organizations are creating preservice experiences that enable patients to get insight into out-of-pocket costs, as well as affordable payment options.
“People are living ‘digital everything’ lives. If healthcare providers don’t engage patients in easy and convenient ways, they will create friction and dissatisfaction. We must take a holistic approach and look at the entire patient financial experience from a consumer perspective,” said Ms. Polika-Engle.
