For decades, healthcare organizations have primarily focused on bolstering payments from private health plans and government insurers.
However, today, the ubiquity of high-deductible health plans has led to a dramatic shift toward the patient as a significant source — as much as 20 percent — of a health system's revenue. As a result, providers are discovering the rules and processes that guided traditional reimbursement strategies don't align with consumer payment habits, preferences or expectations.
"Consumers pay slower ... struggle to pay and have [financial] priorities other than medical bills," said David Kirshner, retired CFO of Boston Children's Hospital and University of Rochester (N.Y.) Medical Center, during a workshop at Becker's Hospital Review 7th Annual CEO + CFO Roundtable on Nov. 14 in Chicago.
The challenges with the changing payment paradigm go beyond just consumer behavior, explained Mr. Kirshner. For example, legacy, poorly-automated payment processes and confusing online portals often deliver patients an uncoordinated billing experience. The inefficiencies in this process not only leave revenue on the table, but also leave patients confused and dissatisfied, even if their clinical care was top-notch.
This content is sponsored by VisitPay
Mr. Kirsher was joined by Todd Craghead, vice president of revenue cycle at Salt Lake City-based Intermountain Healthcare, who discussed the challenges and goals his 23-hospital health system faced to improve its patient financial experience.
After spending decades building its own clinical information system and patient accounting system, Intermountain knew it needed a partner to improve the patient financial experience — especially as patients' out-of-pocket expenses continue to rise.
"It was very important that we were disrupting the collecting and billing system we had in place," Mr. Craghead said. "We also tried to prepare for this growing income from patient responsibility and we needed tools to help us do that."
Intermountain partnered with Cerner, leveraging the EHR company's clinical information and revenue cycle systems. Throughout the system's transition, which began in 2015, Intermountain worried about how to combine its legacy systems with Cerner's EHR, while simultaneously improving the patient financial experience.
To help improve patient financial experience during and after the EHR transition, Intermountain tapped VisitPay.
VisitPay's online portal, which is customizable and allows health systems to maintain their branding and logos, helps patients pay and manage their medical bills through an intuitive web-based interface. It provides a single easy-to-read bill and lets patients view their explanation of benefits and bill side-by-side. Intermountain applied VisitPay’s proprietary scoring and segmentation capabilities to the health system's own patient data to create customized financing options based on the needs of each patient, while remaining fully compliant with its credit risk policies and national regulations. Moreover, these granular analytics enabled Intermountain to prioritize accounts for early-out vendors, as well as actively test and refine financing strategies.
"The [platform] gave us insight and it helped the consumer because it felt like we were talking to them. It was personal. Healthcare is personal," Mr. Craghead said. "Leveraging this technology allowed us though to tailor an experience for folks. … it also gave us the ability to extend the way that we delivered payment plans to our consumer, the patient."
Intermountain opted for a phased roll out of VisitPay. The health system first piloted the platform with its finance team and gradually began testing it with its 38,000 employees. After fine-tuning the platform, VisitPay was introduced to patients.
Since the VisitPay go-live, Intermountain has seen significant improvements in both patient payments and satisfaction.
"Our work with VisitPay was instrumental," Mr. Craghead said. "The platform allowed us to demonstrate a 40 to 50 percent increase in patient satisfaction."
In addition to patient experience, the health system saw its finances improve. "The portal increases the speed to pay to our system, which is helpful for us. It also has helped us to realize … an increased yield," Mr. Craghead said, adding that the health system is on pace to hit a 29 percent risk-adjusted yield lift.
There is a new payer in town — the patient. Most consumers want to pay what is owed; however, legacy billing processes leave them confused and often dissatisfied. In order to ensure proper collections, health systems need to modernize their collections processes to fit their patients' needs and financial situations. Doing so will not only improve the health system's bottom line, but it will also bolster patient satisfaction, which has become an integral component of delivering quality care.