Providers, Patients and Finances: New Guidelines Offer a Roadmap for Communication

New best practices developed by patient advocates and policymakers provide guidance for providers looking to discuss finances with their patients.

moneyWith the rise of high-deductible health plans, patients are paying more out of their own pockets for healthcare, and subsequently they're becoming more concerned about the cost of a trip to the hospital or physician's office, says Joe Fifer, president and CEO of the Healthcare Financial Management Association.

At the same time, providers have been operating without a roadmap for talking to patients about the financial aspect of care.

"When you have a complex environment without an established set of guidelines, the practices are all over the map and really make it very difficult for patients to navigate through these systems," Mr. Fifer says.

In order to address that problem, HFMA recently published industry-wide best practices for improving and standardizing provider communication with patients about financial responsibilities.

Behind the guidelines: Providers and policymakers join forces
The guidelines were developed by a group of industry experts, including representatives from the American Hospital Association, America's Health Insurance Plans, the American Academy of Family Physicians and the National Patient Advocate Foundation.

Former HHS Secretaries Donna Shalala, PhD, and Michael Leavitt advised the group. Former Senate leaders Bill Frist, MD, and Tom Daschle, as well as Clinton administration Deputy Attorney General Jamie Gorelick, also acted as advisers, according to HFMA.

Mr. Fifer says physician input was a key part of the process.

"They helped us clarify when these conversations should take place and when they should not take place," he said.

A blueprint for communication in all settings
The best practices address communications inside and outside the emergency department. For instance, in the ED, the guidelines specify no patient financial discussions should occur before the patient has been screened and stabilized. For emergent patients, providers should talk to them about finances during the discharge process, while hospital or health system staff members can engage with people without an emergency medical condition during either the discharge or the registration process.

The practices also encompass communication in advance of service (before a scheduled appointment, for example). For all settings, providers should have standard language to guide staff through common financial discussions with patients. Among other principles, the guidelines state compassion, patient advocacy and education should be part of communication between providers and the people they treat.

The guidelines also include a section on measurement criteria that outlines standards for evaluating training programs, process compliance, technology, executive level metrics and feedback processes and responses.

In 2014, HFMA will create a program to recognize healthcare providers that demonstrate mastery of the best practices, according to a news release.

Looking ahead: Reception and reaction from providers
Although it's too soon after the release of the best practices to gauge providers' response, Mr. Fifer expects they will welcome the guidelines. Based on the comments providers offered on a draft of the guidelines earlier this year and his conversations with industry members, he says there is a "huge need" for a set of standards like this.

"I think the industry is craving  this," he says. "They're kind of operating in the dark in terms of what's accepted and what isn't. That kind of environment is worrisome for providers of all types."

More Articles on Healthcare Costs:
Doctor, Why Can't You Tell Me How Much It Costs?
More Employee Responsibility, More Unpaid Bills? The Rise of High-Deductible Health Plans and What it Means for Hospitals
Opening Up: How Pricing Transparency Will Change Hospital Benchmarking 

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