How Adventist Health System more than doubled patient payments in a year

Adventist Health System, a Florida based system with 47 hospitals across the Southeast and Midwest, transformed its billing process by asking one question: How can the patient financial experience be as consumer-centric and accessible as possible?

"What we focused on is making the experience of paying a bill pleasing. I know that sounds weird — a pleasing bill," Tim Reiner, senior vice president of revenue management at Adventist Health, said during a workshop at Becker's Hospital Review's 4th Annual Health IT + Revenue Cycle Conference in Chicago.

A "pleasing" bill is no small feat — especially in healthcare, where consumer expectations are incredibly high. Affordability of medical costs ranks No. 1 on Americans' list of priorities, according to a Public Agenda's Hidden Common Ground Initiative report. Additionally, nearly a third (29 percent) of Americans have problems paying medical bills, according to the Kaiser Family Foundation. Whether its greater likelihood of patients having a high-deductible health plan, or their households not having enough savings to cover a medical bill, patient affordability issues pose a serious threat to hospitals.

Adventist Health knew its legacy paper bills and confusing payment portal left patients with an uncoordinated billing experience. Charges couldn't be broken down, and patients couldn't direct their own payment plans. Inefficiencies in these revenue cycle processes not only left self-pay revenue on the table, but left patients — even those with the best clinical experiences — unsatisfied.

As part of a systemwide initiative to serve the consumer, Adventist Health partnered with Simplee to make price transparency and self-service key components of the system's billing experience. Through the collaboration, Adventist Health began using predictive analytics to match patients with a unique payment plan based on their specific needs.

"Our patients are seeking self-service experiences. I know I'll do so many things before I actually call in to talk to someone," Mr. Reiner said. "Why should patients be any different? Providers need to do a better job of putting the right resources in patients' tool boxes to encourage self-service."

Adventist Health's new process prompts patients to pay their bill through an email after receiving care. After clicking on the message, patients can log in, view what each encounter across the system cost, and even set up a PayPal account for quick payments. Simplee's platform also provides a staff experience that allows hospital support teams to see a patient's consolidated bill and recommended payment plan options for that patient.

Adventist Health quickly found the revamp not only encouraged patient financial engagement, but improved the system's financial performance. The system saw its patient payment volume more than double between the second quarter of 2017 and the same period of 2018, from $7.2 million to $25.8 million per quarter. Of its online payments, 29 percent were made from a mobile device, which is higher than retail ecommerce, where 24 percent of payments are mobile. Patients also have the option to pay via paper bills if they wish.

Notably, the Simplee portal allows patients to enter feedback about their billing experience while inside the platform. Adventist Health found consumer satisfaction within the platform often outpaced satisfaction with major brands. The system's Net Promoter Score, a measure of customer loyalty, beat brands like Mercedes Benz, Nordstrom and Comcast, Mr. Reiner said. Its Net Promoter Score was more than twice what the average healthcare organization received.

Mr. Reiner doesn't want Adventist Health's billing improvements to stop there. Looking ahead, he imagines an entirely self-service registration and billing experience that "obviates the need for waiting rooms, or an FBI-style interview before your care about who your next of kin is and who has your will."

"Those are the old way of doing things," he said. "We're trying to make it more consumer friendly and let people self service themselves like they want to." In doing so, Adventist Health has shifted to a paradigm hospitals have long sought — a patient billing experience that works for patients and improves bottom line performance.

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