4 steps for improving patient communication, collections in the age of the high deductible health plan

Emily Rappleye (Twitter) - Print  | 

The increasing popularity of the high deductible health plan has transformed the healthcare revenue cycle, putting providers in a direct physician-to-patient, rather than physician-to-payer, relationship.

This shift to a business-to-consumer model is further cemented as employers attempt to tamp down on rising premiums, causing deductibles to climb. Data from the Kaiser Family Foundation indicates the percentage of insured workers with deductibles of $1,000 or more rose from 10 percent to 46 percent from 2006 to 2015. The average deductible in 2015 was $1,318, compared to $917 in 2010.

As patients shoulder more of the healthcare cost burden, they are beginning to approach healthcare decisions as consumers — and to expect the same level of customer service from healthcare providers as they receive from companies in other industries.

"The revenue cycle is analogous to a retailer's check-out process in that it can either increase or decrease the likelihood of future encounters — even more so given these relationships are more emotionally charged due to the circumstances than say, buying groceries or taking a ride with Uber," said Joe McMurray, vice president of patient experience at Zotec Partners, during a webinar sponsored by Zotec Partners and hosted by Becker's Hospital Review. Zotec Partners, based in Carmel, Ind., provides revenue cycle practice management solutions and services to hospitals and physician groups.

These demands mean providers need to excel in connecting with patients during the billing and collections process or lose out on self-pay revenue. However, many payment methodologies used by hospitals are outdated and inconvenient, according to Mr. McMurray.

"The patient experience must be as close to effortless as possible to achieve the desired result. We must not make the patient work to pay us," said Mr. McMurray.

Here are four steps providers can take to successfully collect from patients with high deductible health plans.

1. Understand the patient persona. Providers can use predictive analytics to better understand their patient-consumer populations. This approach goes far beyond attaining patient credit scores. "Up to 25 percent of patient pay revenue can come from households that have no or thin credit bureau files, which obviously could make these [households] fall outside the capabilities of a credit-based scoring model, because they are essentially 'unscorable,'" Mr. McMurray said.

Instead, predictive analytics allows providers to forecast a patient's propensity to pay based on geographic, demographic, social and historical payment data. Zotec Partners uses a platform that draws from these various data sources to create "patient personas" that can help providers more quickly understand patient payment tendencies and tailor billing interactions to the individual.

2. Determine the probability of friction. Predictive analytics tools can also help providers determine the propensity for "friction." Zotec Partners considers friction to be obstacles to getting a clean claim, appropriate adjudication or appropriate payment. Examples of friction are re-filed claims, an error in the registration process, ICD-10 issues or an inappropriate denial, according to Mr. McMurray. Friction can come from the patient, the insurance carrier or the physician. Preemptively identifying potential obstacles from these three sources can help providers "create paths to eliminate the friction, improve the patient experience and increase collections," Mr. McMurray said.

3. Tailor campaigns to the patient. Getting a clearer picture of patient demographics and potential friction can help providers determine up front the likelihood a patient will pay. "You can craft an experience for your self-pay-after-insurance patients to avoid or tiptoe around friction, such as the patient calling multiple times and/or complaining via another medium, such as social media," Mr. McMurray said.

After pinpointing patients' overall propensity to pay, providers can decide how to most efficiently meet the needs of each one on an individual level. For example, Mr. McMurray cautions against investing large amounts of time and effort on collecting from patients that are already predicted to pay. That time and effort is much better spent on follow-up campaigns to those who are less likely to pay of their own accord. Providers can drill down even further and tailor response strategies to the patient persona. For a millennial patient, a follow-up campaign may come via text, but for a baby boomer patient, it may come via an emailed statement. "One size does not fit all," he said.

4. Provide multiple channels to pay. Although there may appear to be a correlation between patient age and preferred channels of communication, Mr. McMurray also cautioned against making any assumptions about patient preferences. He recommended providers to go back to the data while crafting communication strategies — some patients may be more or less tech savvy than providers expect, or they may use different payment channels based on what is convenient at the time of payment. Giving patients access to a host of options, such as automatic deductions from their health savings accounts, long-term payment plans, mobile options and others, will help boost collections. "Truly the best way to ensure payment is to give patients as many options as possible," Mr. McMurray said. "They may or may not use the same method each time. It's truly about convenience and giving patients options — meeting them where they are."


Watch the presentation on YouTube here.

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