Patients are increasingly basing decisions about their care on concerns about high deductibles and rising out of pocket costs. This in turn affects how satisfied they are with their care, which means revenue cycle management (RCM) shouldn’t ignore a patient’s difficulties in paying their bills.
Mark Spinner is president and CEO for AccessOne, a company specializing in a medical credit card program for hospitals and other financing products. At the Healthcare Financial Management Association (HFMA) conference in Orlando, he spoke to HealthExec about why finance leaders shouldn’t lose sight of patients’ problems with medical expenses.
HealthExec: Why should hospital and health system CFOs be concerned about patients’ rising out-of-pocket costs?
Mark Spinner: With the use of high deductible health plans on the rise, coupled with patients not having enough savings, patients are struggling with their payment balances after the insurance company pays their portion of the bill. This affects patient satisfaction negatively and decreases the willingness of the patient to access care when they need it. With growing patient financial responsibility, healthcare expenses are competing with mortgages, credit cards and other debt families have to juggle. These trends have short and long-term negative impacts on the patient getting the care that they need and the hospital or health system getting reimbursed for the care that they provided
Is it more or less common now than it was before the Affordable Care Act for patients to need some sort of payment plan for their medical bills?
It’s much more common in today’s world. According to a recent study, 69 percent of Americans have less than $1,000 in savings, and high deductible health plans are driving out of pocket costs higher. The cost shift is real and impacting a majority of Americans. In addition, patient-consumers are trained to expect consumer financing options at the point of service in other sectors of the consumer economy (auto retail, home center, leisure goods, etc.). Health systems having a variety of affordable payment options to offer to their patients is a key driver for patient satisfaction.
So-called "surprise" medical bills are becoming a hot topic among policymakers at the federal and state level—do healthcare finance leaders fear or welcome putting an end to balance billing?
Providers look for ways to improve their transparency when it comes to discussing patient financial responsibility by supporting patient consumers earlier in the process and in pre-service settings whenever possible. Many providers are using technology to drive conversations with their patients and help them understand their co-pays, deductibles and estimated balance after insurance. Healthcare finance leaders also want to limit those surprises and make sure payment options are discussed proactively. These healthcare finance leaders and providers are leveraging technology to help them understand the payment ability of the patients they are speaking to, which helps with the sensitivity of the topic, enables them to have the right conversations with patients and ultimately allows for the patient to get the care that they need.
We often hear complaints from clinicians about their EHRs. What about on the revenue cycle side? Are RCM products delivering what systems need to navigate the transition to risk-based revenue models?
There will always be challenges in healthcare technology. However, by having a common system across your hospital or health system will help providers coordinate care, especially with managing higher-risk patients. Providers and health systems can leverage RCM technology to improve communication across providers and give them a deeper understanding of each patient they are engaging with. Having these solutions in place effectively helps in providing access to data, which helps to drive the right care and improve efficiencies, and therefore reducing costs to the provider.