The new out-of-pocket reality: 3 things consumers want fixed yesterday

J.P. Morgan predicts that out-of-pocket patient payments could top to top $420 billion by 2015 — a 68 percent increase in just five years.

Enrollment in high-deductible health plans has tripled since 2009. With this kind of data hitting the headlines, it's not difficult to find articles discussing the rising tide of patient out-of-pocket responsibility. I should know — we pay a marketing analyst to find these stories and circulate them to our management team on a daily basis. What is difficult, however, is to find someone talking about specific solutions to the increasing patient payment responsibility challenge.

That's odd. Isn't the healthcare industry intensely focused on patients? It most certainly is. But it has only been since the patient has started picking up a bigger portion of the payment responsibility that healthcare providers have really started to take notice of how much power the consumer has to impact the bottom line. As a result of this new reality, if a healthcare organization hasn't already dedicated significant attention to this topic, they are likely behind the curve.

While the purpose of this article isn't to discuss specific solutions to the new out-of-pocket reality, what I want to do is send out a rallying cry to the industry to dedicate more resources to uncovering solutions to the patient payment responsibility challenge. This is a significant part of the healthcare dialogue that often does not get the attention it deserves — partly because the key stakeholder (i.e., the consumer) has not really been involved in the past. Those days are gone.

As Becker's Hospital Review covered in a in a 2009 article, "5 Best Practices to Help Address Increasing Patient Out-of-Pocket Expenses," we need to discuss more best practices and we need more minds thinking like consumers. We need to talk more about and discover more of the innovative solutions that startups and large companies are working on that will help address the trends affecting consumers for the good of both the consumer and the industry.

Let me just mention three areas within the scope of the increasing patient payment responsibility challenge where I see significant consumer demand for innovation. In each of these areas, I know of successful healthcare organizations that are partnering with innovative vendors and service providers to tackle these challenges. In future articles, I hope we see more discussion around the specific ways in which organizations are addressing these needs and finding great success as they focus more on the consumer.

1. Price transparency
It is a fact that as consumers pay more out-of-pocket, they will demand more transparency and information.
Consider this: If you haven't researched the growing number of patient-focused price comparison websites, you need to do that immediately.

2. Consumer experience
Hospitals are becoming more aware of the importance of Hospital Consumer Assessment of Healthcare Providers and Systems scores, and Becker's has discussed strategies for boosting HCAHPS scores. However, today's consumers are not only using healthcare context to judge their experience but are also using their everyday consumer experiences (i.e., Facebook, Amazon, Uber, online banking, etc.) as a benchmark.
Consider this: Has your executive team considered what it will take to shift your culture to one that goes above-and-beyond, like Nordstrom's customer environment?

3. Affordability
The "rising cost of healthcare" is a complex challenge with tens of thousands of nuances that will take decades to address. In the meantime, consumers are faced with growing out-of-pocket costs, and they need affordable monthly payment options for large (sometimes massive) balances.
Consider this: What measures are you taking to more clearly communicate to patients their total out-of-pocket cost and to provide them with financing options to pay up-front for large out-of-pocket expenses?
These and other areas of consumer need are being addressed today in innovative ways throughout the country and you should be excited about how these innovations will help your organization succeed in the future.

Nick Sorensen is the co-Founder and COO of American HealthCare Lending, a leading non-recourse patient financing company and creators of the Financing as a Service™ model. Health systems, physician groups, and other healthcare providers in the bariatric surgery, fertility, cosmetic dentistry, plastic surgery, spine and neurosurgery, and behavioral health markets throughout the country subscribe to American HealthCare Lending's online patient financing platform in order to help their patients pay for elective surgeries, high deductibles and large out-of-pocket medical expenses. Follow him on Twitter: @americanhcl


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