What's next for patient financial engagement?

The way healthcare organizations communicate and collect out-of-pocket balances is due for a reinvention — from the perspective of improving both the patient experience and revenue cycle management (RCM).

During Becker's Hospital Review's 7th Annual Health IT + Digital Health + RCM Annual Meeting, in a session sponsored by Flywire, Joseph Koons, senior vice president and chief revenue officer for Baltimore-based LifeBridge Health, Brad Tinnermon, vice president of revenue cycle at Banner Health (Phoenix) and John Talaga, EVP and GM at Flywire discussed strategies and tools that health systems can implement to bring patient-facing RCM processes in line with consumer expectations.

Four key takeaways were:

  1. Traditional patient engagement methods are losing their effectiveness. According to a Flywire survey of 2000 patients, 47% prefer not to receive paper billing statements, while a 2020 survey by telecommunications company Hiya, indicated that 48 percent of phone calls Americans receive go unanswered. "Who answers their cell phone when it says, 'Unknown caller' or 'ABC Hospital?'" Mr. Talaga asked, underscoring the need for a more digital and personalized approach to engaging patients. 

  2. Digital engagement tools are available but must be more thoughtfully designed. Some healthcare organizations have initiated their engagement reinvention journey by implementing digital front doors and text/email reminder systems, but are recognizing that this initial attempt at digital transformation is due for a rethink.

    "In the Banner space, digital engagement blew up over the last few years, but now we're reeling it back in because it's fatiguing," Mr. Tinnermon said, explaining that patients were being sent too much information too often in an uncoordinated fashion. "The challenge of the digital front door is tying different departments and initiatives together with scheduling and the revenue cycle."

    As a solution to the avalanche of digital messaging, session participants stressed the need for simplification and consolidation of billing statements, for example by sending a single statement online while allowing recipients to opt-in for paper-based statements.

  3. Rising medical costs further underscore the need to reinvent the patient financial experience. With medical bills being a leading cause of bankruptcies and many Americans impacted by continuously rising out-of-pocket costs, providing a consumer-friendly approach to pay outstanding balances is another key measure for improving the patient experience.

    One aspect of achieving this is creating an online self-service environment that, in addition to self-scheduling and self-check-in, enables self-pay — an experience Mr. Koons compared to that of using self-checkout at a store. Another aspect is providing cost estimates of what the patient would owe once they have digitally checked in. The third aspect is offering options for resolving that balance, including via extended payment plans based on patients' capacity to pay.

  4. AI-assisted chatbots and staff-assisted chat are the true North Star of digital engagement. AI-powered chatbots are transforming the way consumers seek out information in areas outside of healthcare. Yet, healthcare users are still directed to log onto websites to access personal health records, billing statements and other financial details. By replacing unidirectional text messaging with technologies that enable users to engage in a dialogue and access relevant information with less effort, health systems can significantly improve the patient financial experience.

    One participant representing a payer said her organization has implemented an AI-driven staff-assisted chatbot to answer member questions about billing. "It's been a crowd-pleaser," she noted. Another attendee representing a pediatric hospital in Washington, DC, said her institution is considering introducing a similar chatbot at the pre-appointment stage to help identify patients in need of financial assistance earlier in their patient journey.

    "Our providers will tell you they don't want to have [a financial] conversation with a patient because a lot of patients will think [how they answer] is going to impact their treatment," another participant said. "There's no truth to that, but providers are clinicians, they should be practicing medicine and taking care of patients and shouldn't have to do financial stuff."

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