Hospitals and health systems across the nation are faced with many revenue cycle management challenges, some of which are caused by the rise of consumerism, the transition to value-based payment models and high-deductible health plans.
This content is sponsored by Change Healthcare
In recent years, multiple forces have pushed patients into becoming more involved in healthcare decision making. Greater transparency into provider costs and performance has given patients insight they can use to shop around for care. Patients are also shouldering a greater percentage of their healthcare costs due to the increasing popularity of high-deductible health plans, making the consumer the new payer.
"The patient is becoming increasingly more demanding and increasingly more responsible for the cost of care," said Keith Slater, vice president of business development at Change Healthcare, at Becker's 8th Annual Meeting in Chicago.
With many patients unable to afford their out-of-pocket insurance costs or to pay off their account balances, many hospitals across the nation are seeing their bad debt rise. Several of the executives at the roundtable said this trend has affected their organizations. A finance executive from an Illinois hospital said his organization has been concerned about high-deductible health plans for a few years. His hospital saw a 17 percent increase in bad debt in the past year, which still falls significantly below the 30 percent year-over-year growth in bad debt some hospitals are seeing.
To address this challenge, hospitals and health systems must stay on top of their patients' wants and needs. With the shift to value-based care, patient treatment goes beyond clinical care to include factors such as cleanliness of the facility, staff behavior and the billing experience. This transition makes it vital for provider organizations to ensure patients are satisfied from admission to discharge and also after they leave the hospital.
Improving the patient experience
The shift to value-based care is the top driver of consumerism for hospitals, said Matias Klein, vice president of product management at Change Healthcare, during the executive roundtable. With the rise of consumerism in healthcare, patients now expect a more retail-like experience from hospitals and health systems, and organizations that fail to adapt to this new environment may see their finances suffer.
Although patient experience improvement touches every part of an organization, one critical area of focus for hospitals and health systems should be payment and billing.
"If the bill a patient gets isn't what they expect…that could be the last impression they have of your organization," said Mr. Slater. "You can't not look at the process."
Improvement in this area requires provider organizations to set expectations up front so patients don't get upset on the back end. By opening up communication and providing patients with price estimates before they receive care, hospitals and health systems can improve the patient experience and also increase the likelihood of collecting payment.
Provider organizations are largely in agreement about the difficulty of collecting from patients post-visit, and upfront discussions go a long way to make patients aware of and prepared for their financial responsibility.
Providing a cost estimate is only one part of the equation. As financial responsibility moves to the patient, hospitals and health systems must also make it simple for patients to pay their bill. This involves offering patients multiple ways to pay, including at the point of service and online.
How data analytics can help
The first important step to improving patient experience is gaining insights into patient behavior and preferences. To explore patient experience issues at a deeper level, many hospitals and health systems are using data analytics.
"If you don't have good analytics, you can't predict behavior and you can't improve patient experience," said Mr. Klein.
Data analytics solutions can help hospitals and health systems increase revenue and get a leg up on competitors in their market. In the past, hospital revenue cycle problems were managed as they arose. Today, organizations can use data analytics to take steps to minimize or even avoid these issues.
For example, hospitals can use data analytics to determine a patient's propensity to pay. This will allow provider organizations to determine if a patient is likely to pay their bill without additional follow up, if they need a reminder such as a phone call or letter, or if they're likely to never pay their bill. Hospitals and health systems can use this information to determine areas where they could improve the process, such as by providing more ways to pay, to help make the patient's experience better and have a positive impact on the organization's finances.
Conclusion
Hospitals and health systems are facing a myriad of revenue cycle challenges as the industry makes the monumental shift to value-based care. The key to navigating this transition is to take steps to improve the patient experience.
Boosting patient satisfaction requires organizations to "create an integrated experience where patients don't have the opportunity to get unhappy," said Mr. Klein.
About Change Healthcare
McKesson Technology Solutions and Change Healthcare have merged to create a new healthcare technology company. Visit ChangeHealthcare.com.