Six things you should know about your patients and their medical bills

Navigating the world of unpaid medical bills is difficult for everyone involved. It's a complicated, confusing, often unforgiving cycle, with tremendous consequences for both patients and providers.

Patients are in a system that often feels like it is designed to baffle them. They are struggling to understand what they owe, to whom, and why. They risk financial ruin – and can jeopardize their health and lives – if they make a wrong move.

This situation is no easier for providers. More and more, the ability to provide and invest in quality care is being compromised by mounting bad debt associated with patient receivables and falling patient satisfaction scores due to antiquated patient payment and collection processes.

As an industry, our first instinct is to focus on the big players in the healthcare system - insurers, fellow providers, state and federal Government - when contemplating solutions to these problems. But, do we spend enough time getting to know and understand the user of the system – our healthcare consumer? As in all industries, our consumer is unique. They have certain needs and expectations and vulnerabilities that, in order to serve them to the best of our abilities, need to be understood. A 20+ year career spent communicating with patients about their healthcare financial responsibility has taught me several important things about your healthcare consumer:

1. They want to pay you. The good news first: most of the time, patients want to pay their medical bills. They are not looking to duck their responsibilities. The bad news? We don't make it easy for them to pay. As an industry we spend a lot of time discussing reimbursements, payment reform, price transparency, HCAHPS scores, etc. But, maybe it's time to take a step back, engage our patients in the discussion, and start with this simple question: "what can we do to make it easier for you to meet your financial obligations?"

2. They are overwhelmed. Your healthcare consumer has likely just experienced, or is preparing to experience, one of the most trying, scary times of their lives. Their head is swimming with medical terms, treatment protocols, appointment dates and prescription instructions. And, in this state of bewilderment and vulnerability, we hand them a packet of dense, complicated administrative paperwork and ask how they will pay their portion of the bill. Knowing how and when to effectively communicate with people in this state of mind, and providing information and options that are easy to understand, will go a long way to restoring a sense of control and dignity that is commonly lost during a healthcare encounter.

3. They have income, are insured, and still can't afford your care: According to recent research, since 2014, your patients' out of pocket healthcare costs have grown 9% while their wages have grown 1.9%. Three-quarters of Americans have no savings yet 30% have a high deductible health plan. Almost fifty percent of Americans could not come up with $400 for an emergency without borrowing the money or selling something, yet the average family deductible is $4,000. And, one in four of the patients in your waiting room today walked in already saddled with medical debt. This is the new Self Pay and their faces are familiar. They are your neighbors and friends. They see you in the grocery store and at the high school baseball game. They work in your hospitals caring for your patients. They may even be you.

4. They are avoiding you. According to Gallup, 30% of Americans have either skipped needed care or delayed needed healthcare due to concerns about costs. No surprise now that you have read #3 above. Your patients are being forced to choose between needed medical treatment or paying for rent and food. It's a heartbreaking choice no one should have to make.

5. They want and need options. We expect to have payment options when purchasing a home, car, furniture, education. Why not medical bills? Most patients don't think to even ask about options or other solutions to paying off a significant medical bill – and much of the time, providers don't have a lot to offer them. To reduce the bad debt burden, we have to offer patients more ways – and more time – to pay what they owe without forcing them into high-interest credit agreements that can lead them into financial ruin.

6. They trust you. You are an economic and moral leader in their community. They entrust their life, and the lives of their family to you. They believe you have their best interest at heart. Do not shy away from this great responsibility and opportunity during the non-clinical moments of their experience. You have worked too hard to build your brand and they are relying on you and will reward you for your support.

Craig Hodges is CEO of CarePayment, a patient financial engagement company that provides flexible, easy to understand, zero interest loans to patients.

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