As more patients choose high-deductible health plans and take on a greater share of healthcare expenses, the reality of that newfound financial responsibility can be daunting.
"This year for the first time the average deductible is more than the average expense of healthcare. On an actuarial basis, the consumer is going to pay for almost every healthcare dollar they incur," said T. Scott Law, founder and CEO of Zotec Partners, a provider of specialized medical billing and practice management services. "That is an alarming trend and it's alarming to patients to be the consumer."
Few healthcare consumers know how to navigate the revenue cycle. Instead, many expect hospitals and health systems to provide a seamless billing experience on par with other industries.
Becker's caught up with Mr. Law to discuss his best and worst experiences as a consumer, what makes an excellent encounter and how to make exceptional customer service the standard for patients in the revenue cycle.
Question: What do you consider your best personal consumer experience?
T. Scott Law: Uber, Amazon Prime and Starbucks are the three best examples, and all three have greatly influenced our delivery, as so much responsibility for the healthcare dollar shifts to the consumer. Consumers expect that same kind of experience from healthcare. They want to use computers; they want to use handheld devices and have a friction free process. We need to make sure they are billed appropriately and make sure it's timely and convenient for them to make a payment. In those transactions, the healthcare industry is by and large lacking the 'e' part of ecommerce.
Q: What makes Uber, Amazon Prime and Starbucks consumer experiences stand out?
TSL: There should be one healthcare demographic record you can have and take with you, just like a Starbucks card, or your Uber account on your phone, or your Amazon Prime account. That way, you can focus on getting care at the doctor as opposed to filling out forms, getting registered or having your insurance card copied. All of that would go away — you could walk into the doctor's office and answer questions about your health record that are appropriate for the physician you are seeing. It would make the entire transaction much more seamless.
The consumerism of healthcare impacts patients' well-being. Patients already have something wrong; otherwise they wouldn't be going to the doctor. When they walk in the door, they are nervous and tense, and experiencing something familiar can really diffuse the situation. It gives them control versus leaving them susceptible to the big, scary healthcare giant.
Q: What was your worst consumer experience?
TSL: If you try to get support on a PC or support on another piece of equipment, you may be transferred to someone in a foreign country who does not understand you. Certainly in healthcare, if you get transferred to a call center offshore, they don't understand what the patient is feeling because they don't live and breathe that. Healthcare is still a local business, and when I hear that patient phone calls are being outsourced, I always get concerned.
Q: How did these experiences influence your patient billing strategies at Zotec?
TSL: We've spent a lot time addressing the patient experience, whether it is text messaging patients their bill, or in our phone center, we record every phone call and look at those for quality assurance purposes. We take care of our clients' patients during that process. Our website interfaces with our portal for the purposes of making payments, setting up easy payment plans, requesting discounts and making complaints — all of the things consumers do.
The revenue cycle is really the only exposure patients have in healthcare to someone who is not related to treatment or care. It's a very important job. We are always looking at the overall trends of patient behavior so we can continue to develop products that meet patients where they are.
Q: What's one thing that's surprised you about consumer preference in the billing process?
TSL: What has most shocked me is physicians not recognizing the impact of the patient as a consumer, versus the patient as a patient. By that I mean patients are coming into physician offices way more educated, with Google and the internet, and they're almost self-diagnosed by the time they get there. The revenue cycle side of the business has the same pressures. People are using social media to post vicious comments about physicians or physician practices over simple billing issues that get blown way out of proportion.
It's been surprising to see how quickly small mistakes are exacerbated into huge problems with social media. You have to be able to monitor social media, address the mistakes and try to move forward with it.
Q: What do you see as the biggest challenge on the horizon for healthcare organizations in terms of billing and revenue cycle management?
TSL: In the next year or so, I think the exchanges will be a challenge, as will the Medicaid rolls. Individual participation in Healthcare Exchanges and expanded Medicaid coverage will become major challenges for states as federal government subsidies go away. We are going to be thrown back into a state of flux until we can figure it out. Then there are all the government regulations around quality measures, pay for performance, accountable care organizations and the like. It's a very interesting time right now for healthcare, for the physicians and providers especially, to figure out what's going to happen. The impact of the election will be enormous on healthcare for the next five to 10 years.