Getting Rid of the Financial Guessing Game: Benefits of Providing the Cost of Care Up Front

In his conversations with patients, Gary Friestad, corporate registration manager at Roseville, Calif.-based Adventist Health, has found many people's greatest source of dread when entering a hospital isn't what's about to happen to them medically but the stress they are about to undergo financially.

check"Insurance policies are so complicated, and copayments have been escalating," Mr. Friestad says. "Everyone knows part of the payment is going to be on them."

Adventist has helped alleviate some of this anxiety for patients with a Web-based patient access intelligence program from MedeAnalytics that computes and displays the total charge, what will be covered by health insurance and what the patient owes during the initial registration process. The health system has implemented the program at all of its 19 hospitals across four states, and Mr. Friestad says it has benefited both the health system and its patients in a couple of ways.

Better cost calculation advantages for providers and patients
One major benefit to being able to provide patients with accurate cost estimates up front has been the rise in point-of-service collections, Mr. Friestad says. The portion of the cost of care that patients are responsible for has traditionally been difficult to calculate, making them harder tocollect, he says.

The collections process has improved with the new system, however. Because all Adventist hospitals have uploaded all of their payer contracts and rate terms into the platform, providers can calculate full estimates and print out a notice for the patient that looks like the explanation of benefits form people get from their insurers when a claim is processed, according to Mr. Friestad. The program also allows the hospitals to determine if patients qualify for benefits or programs such as Medicaid.

As a result, up front collections have increased in a "fairly dramatic manner" and the hospitals have seen a decline bad debt, says Mr. Friestad. Adventist's Simi Valley (Calif.) Hospital implemented the program before the rest of the system and achieved 135 percent of point-of-service cash collection goals within 18 months, according to MedeAnalytics. That hospital's success was a major influence in Adventist's decision to install the program at all of its facilities, Mr. Friestad says.

The system also benefits hospital staff members by provided them with a list of tasks they need to complete during the registration process.

"They say, 'It really helps me remember to do my job and consistently reminds me of things I might have overlooked,'" Mr. Friestad says of staff feedback. "If a task is incomplete, it will stay on the work list for that person for 24 hours."

The program also records whether or not registration staff members complete tasks in a timely manner, he says. This allows management to evaluate performance, and the system hopes that data could eventually become a tool for reducing initial claim denials.

Improvements in patient experience and perspective
Adventist isn't the only one benefiting from the ability to assess the cost of service up-front. Patients appreciate knowing what their financial obligations are, and that knowledge has had a dramatic impact on their satisfaction and how they view the health system, Mr. Friestad says.

"It makes patients confident in our professionalism," he says.

Overall, Mr. Friestad says having the capability to accurately assess costs during registration helps Adventist stand out and distinguish itself from other providers, in addition to benefiting patients and hospital workers.

"It makes Adventist health unique at the moment," he says. 

More Articles on Healthcare Costs:
The Frail Anatomy of the U.S. Healthcare System
Cashing in on Revenue Cycle Improvements
Can Budgets Drive Healthcare Quality? 

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