Health systems exist to care for patients; they truly want to provide the best outcomes and a great experience for every patient.
Yet when it comes to the financial side of care, there is usually a sizable disconnect between the desired experience and the reality.
At best, most patients would describe their interaction with the billing process as complex, confusing and cumbersome. From phone calls asking for payments to mailed materials that may say “This is not a final bill – do not pay” to handwritten forms asking for information already provided, healthcare doesn’t compare favorably against the automated, streamlined processes patients encounter in other aspects of their lives, such as with airlines, banks and more.
Too often, patients find the healthcare financial experience not only inconvenient, but also unclear — even worrisome — because they don’t know upfront how much their care could cost out of pocket. The frustration is understandable as, in other industries, they are given complete transparency to what they may owe prior to service.
That’s not surprising if we take a moment to think about it from a patient’s perspective. Annual deductibles now average around $1,500, yet recent findings show that 69 percent of Americans have less than $1,000 in total savings and 34 percent with no savings at all. Is it any wonder that cumbersome processes and lack of transparency create dissatisfaction and worry?
For financial leaders, that question is not just a rhetorical one. Patient satisfaction and engagement directly affect health system reimbursement rates. According to an analysis by R1 RCM, for example, patient collections increase from about 40 percent to about 60 percent when potential out-of-pocket costs are clearly articulated prior to service. That amounts to a substantial boost to net revenue.
All of these factors point to a tremendous opportunity for health systems to use technology and creative design concepts to shape a new, different and more engaging patient experience. By offering patients greater transparency and control over their financial situation in the way they want to interact – such as smart phones, health systems can boost both patient satisfaction and their own financial stability.
Adopt the patient’s view
Simplifying and reinventing the financial experience requires building it from the patient perspective. That means automating it — as in other industries like travel, retail or investing — and putting many revenue cycle processes straight into patients’ hands. This includes registration, scheduling, financial estimates and counseling, and bill payment processes. For the patient, this could be letting them schedule their appointments and fill out registration forms online, either from their own devices at home or from self-service devices located at the point of care.
It also means that the revenue cycle must be viewed holistically, starting at the time of scheduling rather than after completion of the clinical service. Scheduling and registration have become pain points for both patients and physicians alike. However, intuitively-designed digital self-service patient experience platforms allow patients to manage their data across an entire integrated health system, appointment to appointment. At the point of service, self-service check-in options like those used in airline terminals can help reduce wait times. After service, electronic bill-pay can offer further convenience.
For health systems, these same platforms can improve access to key patient demographic, insurance and other information — as well as ensure its accuracy and secure retention. Additionally, robust rules engines and machine learning can enable more proactive and productive workflows to:
• validate insurance plan and benefit eligibility;
• validate medical necessity;
• identify authorization and referral requirements in advance of service; and
• estimate patient out-of-pocket costs prior to service
Health systems benefit from more efficient workflows that reduce staff costs, improve patient cash yield and lower patient bad debt — all while significantly improving patient satisfaction and engagement. In addition, these processes make it easy for a satisfied patient to share their experience online – further building the provider’s brand.
Greater patient engagement, satisfaction, stronger revenue
It might seem unusual to factor patient engagement strategies into revenue cycle management decisions. However, the experience patients go through to schedule an appointment, check-in at a facility, get financial support and pay their healthcare bills has a substantial impact on their overall satisfaction. That, in turn, has a material impact on a health system’s business outcomes.
Today’s patients want transparency and control over their healthcare finances. Health systems that take an automated, self-service approach to the revenue cycle can start to transform a confusing and inconvenient process into the familiar, engaging and welcoming experience patients desire.