Patients are living in a digital world, but are providers? Digital approaches to engagement are closing the patient experience gap

Digitally transforming patient engagement isn't simply about adding digital channels to a healthcare system's billing program. It's an integrative approach designed to deliver the right message at the right time based on patients' preferences and behaviors.

In October, at Becker's 5th Annual Health IT + Revenue Cycle Conference in Chicago, RevSpring hosted an executive roundtable to explore how healthcare organizations are breaking out of paper-driven processes and using digital communications and an omnichannel approach to reduce costs, drive faster responses and create a better patient experience.

The patient experience gap

RevSpring is committed to providing solutions that can help providers connect more effectively with patients. To fulfill this goal, RevSpring has conducted several surveys to gauge the current state of the patient experience, as well as what patients would like their experience to look like.

Kristen Jacobsen, RevSpring's vice president of marketing and product management, highlighted four aspects of the patient experience gap:

  • Paying on time. Close to half of patients (49 percent) said they would be more likely to pay on time if payment plans were more flexible.
  • Reminder preferences. Over one quarter of patients (28 percent) would like better reminders. Close to half (45 percent) prefer email reminders and nearly one third (29 percent) prefer texts.
  • Help paying electronically. One quarter of patients would like to only receive bills electronically, but just 8 percent currently receive bills electronically. Over two thirds (69 percent) say they either weren't offered the option of paperless billing at the time of service or don't remember being offered this option. This represents a huge opportunity for providers.
  • Easier payment options. Some patients (15 percent) feel that paying for healthcare is too time consuming and 12 percent believe that payment options aren't convenient.

Ms. Jacobsen noted, "Healthcare is one of those rare industries where if the customer doesn't pay a bill on time, the provider will often wait another 30 days to send another communication. Patients want to be reminded of their obligation. When they pay digitally, it's inherently quicker. Unfortunately, we are still making it difficult for patients to pay online."

Marty Callahan, RevSpring's president of healthcare market, observed, "It's possible for a consumer to get a credit card in minutes and retailers continually mine customer data to improve the customer experience. Healthcare is 25 years behind financial services."

Although patients are ready to pay their healthcare bills online, only 14 percent of CFOs surveyed by RevSpring in 2018 said that their organization is very prepared to manage the financial impact of healthcare reform with their current financial planning processes and tools.

Here are the top patient collections technology challenges identified in the 2018 survey of CFOs and vice presidents:

  • Three quarters of respondents said the cost to purchase collections technology and tools is out of their budget.
  • Nearly two thirds (63 percent) indicated that most of the technology available is not effective and they face current technology limitations.
  • Close to two thirds (62 percent) said they don't have enough associates to effectively collect from patients.
  • Over half (53 percent) suggested that their organization isn't aligned with making patient collections a priority.

Roundtable participants echoed similar obstacles. One executive, a CFO from a community hospital in the Southwest, reported that it takes their EHR vendor six months to a year to make the necessary system adjustments for a new vendor. Another participant who holds a revenue cycle support position at an academic medical center in the South, noted that internal IT resources are often not available for new technology projects, even if a vendor could be ready in 90 days.

Adopting an omnichannel communication strategy

Omnichannel communications put the patient first. Communication channels are streamlined into a centralized engine that deploys communications based on patient data such as preference and engagement behavior.

Mr. Callahan said, "One of the challenges is coordination. How do you ensure that you suppress a print job when you send out electronic communications? The last thing you want to do is to confuse a patient and overcontact them. RevSpring ensures that there is a process to integrate systems so data can drive communication decisions. We want patients to get a message that's personal to them."

With RevSpring, organizations can set up business rules to govern patient communications. For example, if a person doesn't open an electronic message, the system's automated workflows will revert back to paper. By acting on data and making changes in real time, RevSpring ensures that clients get the best responses and highest rates of return.

Another critical aspect of omnichannel communication is message content. Retailers routinely target consumers based on an understanding of what they want and need. The healthcare industry must think about communications in a similar way and determine how to touch patients on their terms. For example, patients who are good payers should get a different message from someone who needs a payment plan.

"We want to send the right communications via the right channels, so healthcare systems can be efficient with every dollar they spend on communications. Although digital communications are less expensive, they still have a cost. Sending communications that are ignored simply wastes money," explained Ms. Jacobsen.

The key to RevSpring's success is analytics. The company uses consumer data to build predictive and response models. Predictive models anticipate which patient attributes are associated with likelihood to pay. Response models determine who will respond to particular messages. This information is used to tailor messages and make them more relevant to patients.

Patient engagement systems in action

Patient engagement often begins before the patient ever sets foot in the hospital or physician's office. RevSpring allows healthcare systems to send out pre-service appointment reminders and messaging. These can include wayfinding information, as well as alerts about anticipated bills. One client, for example, proactively notifies patients that following surgery, they will receive one bill from the surgeon's office and one from the anesthesiologist.

Text messaging is popular with many patients. A RevSpring customer recently implemented text messages related to payments. In two months, 50 percent of patients had opted in — an increase from just 2.5 percent before.

Ms. Jacobsen said, "On average, this organization's patients are paying about 12 days faster and 12 percent are paying before they even get a bill. There are very low opt-out rates. Mobile payments have increased, and more patients are paying online, which is the channel we wanted."

In some cases, providers offer an estimate of charges and ask patients to approve payment up to a certain amount. The providers' office swipes the patient's credit card, and this information is stored in the system. Once the claim is adjudicated and the statement is delivered, the credit card payment is immediately processed, and the patient receives a message.


Digital communications are a win for both healthcare providers and patients. Sending these messages, however, is often easier said than done. According to Ms. Jacobsen, "Having a patient's mobile number and email address is one thing. Knowing what to do with that information is another."

Implementing an omnichannel patient engagement solution can help. Moving to digital has cost advantages for providers. It's a faster response mechanism for payments and when used properly, it's possible to reduce communication costs. In addition, patients prefer to interact with healthcare systems in the same ways that they deal with retailers. As a revenue cycle director for a 650-plus physician network in the Midwest noted, "I think patients are way more ready for this than we are. I think it's a mandate from the customer."

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