Patient as Payer: Navigating the New Costs of Care

The idea of “patient as the payer” represents a shift toward patients navigating higher costs and greater financial responsibility when it comes to their healthcare.

 Beto Casellas, executive vice president and chief executive officer for CareCredit, took the time to speak with Becker's about how the Coronavirus (COVID-19) pandemic has magnified many of the challenges patients face when it comes to paying for their healthcare while exploring opportunities for payers and providers to build better financial experiences with them moving forward.

For more than 30 years, CareCredit has been a valuable financing option for treatments and procedures that typically are not covered by insurance, or for times when insurance doesn't cover the full amount. CareCredit is also used by cardholders to pay for their deductibles and copayments. Providers who accept CareCredit receive payment in two business days, with no liability1, and more than 12+ million cardholders can pay for the care they want or need at 240,000+ locations throughout the United States.

Question: Can you speak to some of the financial considerations that are currently influencing patients’ decisions about care, and how these have become magnified by the Coronavirus (COVID-19) pandemic?

Beto Casellas: Since the onset of Coronavirus, Americans have approached their health and finances with new levels of urgency and concern. Many are struggling with job loss or disruption, and those who are employed must think about their job security and how they would cover the costs of themselves or a loved one getting sick.

In these difficult economic times, high out-of-pocket costs, which can be a challenge for families to absorb even under normal circumstances, can become an even more significant barrier to care. Many patients say they will delay or go without necessary treatments or simply decline a procedure due to the uncertainty related to cost2 Because patients don’t always know what the cost of a procedure will be beforehand, they’re often willing to compromise or settle to avoid expenses they don’t think they can cover.2

While these trends may be concerning, they aren’t new. Patient needs were evolving well before Coronavirus , with a growing demand for price transparency, online provider information, easy comparison shopping, and appealing payment and financing options3. With an unprecedented number of patients now facing new financial pressures as a result of Coronavirus , I expect the economic needs of patients will become even bigger considerations moving forward.

Question: What do you think will be most important as payers and providers adapt how they engage with patients in this new healthcare landscape? What could these new relationships and experiences look like?

Beto Casellas: As payers and providers adapt how they engage, I think it will be essential to prioritize transparency, keeping in mind the burden of economic disruption that patients are shouldering today. Uncertainty around healthcare costs can be a significant factor impacting patients’ relationships with their healthcare providers. Approximately 65% of patients CareCredit surveyed said they would consider switching providers after receiving an unexpectedly high bill, and 28% said they would very likely do so.2 Nearly 59% would consider switching providers if the office staff could not tell them the cost of a visit or procedure.2

Patients today are looking for candid, straightforward and supportive conversations about their healthcare costs and payments and may be particularly receptive to exploring options and payment plans that could help them find a path forward with the care they need.

Question: More broadly, what steps can health systems take to optimize and account for shifts in patient financial responsibility without assuming the payment risk or collection expense?

Beto Casellas: I think the goal should be tapping into the consumer-driven mindset of today’s patients and empowering them to take charge of their financial situation. Leveraging user-friendly technologies can help patients better navigate and understand the costs of their care. This can include offering convenient options like telehealth appointments, the ability to pay with payment solutions using a smart device, money-sharing apps or a credit card on file, and also the option to pay online or receive an electronic receipt as they would with many other purchases.

Another factor is discussing the best ways to partner with patients to secure the care they need, from resource options that can help in areas like financial counseling to payment plans, to helping identify out-of-pocket costs and copays. Patients today want more options when it comes to offsetting their high-deductible healthcare plans, and there is an opportunity to talk to them about estimates for planned care over the coming year so they can make more informed decisions at the time of their open enrollment. Helping patients understand their financial responsibilities – including copays, deductibles and options to make payments easier – is an opportunity to build loyalty and stand out.

Question: Let’s talk about third-party financing options. What do you wish more people understood about the benefits these options have for patients and providers?

Beto Casellas: Rather than covering the full cost of care upfront, patients may be relieved to know there are third-party financing solutions they can use to manage payments within their family's budget. By using a credit card with a revolving line of credit dedicated to their health and wellness, they can free up their bank accounts and general-purpose credit cards while making monthly payments over time.

Third-party financing options like a personal care credit card allow patients to pay for their out-of-pocket healthcare costs with payments that fit within their monthly budget, without the health system assuming the payment risk or collection expense. The value for providers is that they receive payments quickly and with no liability1 should the patient not make their payments. An additional benefit is that time and resources that were formerly tied up with billing and collecting payments can now be spent on patient care.

Question: Do you see a connection between current consumer trends and decision-making and the healthcare consumer experience? What are some of the most concerning gaps, and how can they be addressed?

Beto Casellas: Even before the onset of Coronavirus, we were noticing a convergence of the general consumer experience and the healthcare consumer experience, with patients looking for more rapid and seamless interactions. Consumers today have become self-directed and digital in their buying preferences – researching product reviews on Google, Yelp or consumer blogs, using smartphones to find the best prices and making purchases online. They expect a fast, intuitive purchasing experience when it comes to healthcare too.

As providers prepare for the “new normal” of a world influenced by Coronavirus, they will need to consider that patients’ desire for more convenient healthcare interactions has only grown during this time. For example, approximately 5% reported that they or a family member used telehealth for the first time during the Coronavirus pandemic, and the vast majority (88%) of those new to telehealth said they would use it again.4

Convenient features like telehealth consultations and contactless payments will become critical for providers who want to provide positive experiences that attract patients, build loyalty and sustain their practice. It’s about taking what we’re learning today and using it to adapt and improve the patient experience for tomorrow.

 

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1Subject to the representations and warranties in your agreement with CareCredit including but not limited to only charging for services that have been completed or that will be completed within 30 days of the initial charge, always obtaining the patient’s signature on in-office applications and the cardholders’ signature on the printed receipt.
2CareCredit, Understanding the Medical Journey Research, Aug. 2019
3Improving patient financial communications, https://www.mgma.com/resources/financial-management/improving-patient-financial-communications
4Price Waterhouse Cooper, The COVID-19 pandemic is influencing consumer health behavior. Are the changes here to stay?, April 2020

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