In a recent survey by Waystar, 52% of patients indicated that they were more concerned with billing than clinical quality. WHAT? It seems unthinkable that patients seeking care are less concerned with the quality of care they receive than the cost? And yet, there is a good reason for this. It hasn’t been that long since health care consumers were pretty much fully insulated from the true cost of health care. Yes, there were co-pays and sometimes co-insurance, but in general the overall deductible and out-of-pocket maximums were low enough that patients weren’t really concerned what the care they were receiving cost. Years ago, the adage was that you’d hit your out-of-pocket maximum by the time you’d hit the button on the elevator checking in for an inpatient stay. And, for the most part that was true.

That is no longer the case. Since 2000, hospitals have delivered more than $700B in uncompensated care. Cost shifting to patients has been occurring for a number of years, with the advent of high deductible health plans (HDHP). Today, approximately 53% of Americans are covered under a HDHP. Per the IRS HDHP guidelines for 2022, the MINIMUM family deductible is $2,800 and the total out-of-pocket MAXIMUM is $14,100. Total family out-of-pocket costs in 2003, according to the Kaiser Family Foundation were $1,231, compared with today’s expense of over $4,000.

This is complicated by the fact that today, 56% of American’s don’t have $1,000 in savings to cover an emergency cost. Even more surprising, is that figure is DOWN from 69% that couldn’t cover that expense in 2019. Combine that with inflation at 7% (the highest it has been in FORTY years) and it is no wonder that patients are reluctant to seek care except in emergency situations.

Accommodating consumer preferences when it comes to health care payments has never been more critical for shoring up revenue cycle operations. Half of patients pay bills late. However, there are strategies health care organizations can employ to ensure that they capture every dollar possible.

• First, recognizing that it cost’s twice as much to collect from patients than it does from payers. Is the patient correctly classified as self-pay or is there disability, work comp, retroactive Medicaid or other coverage that has been overlooked? Start there!
• Move from paper to electronic billing. While no small task, one study shows that change alone reduces payment time from twenty to nine days.
• Adjust collection processes to collect payment from patients prior to services being rendered. Acknowledge that you’re 20% less likely to collect once the patient leaves the building. This requires a fine-tuned patient cost estimator that will correctly reflect insurance payments and patient responsibility.
• Make the bills easier to understand. We’ve all received explanation of benefit in the mail that says “THIS IS NOT A BILL,” but when you do receive a bill it isn’t always easy to decipher. What are the charges and what do I actually owe? Make it clear.
• When collecting, give the patient multiple options for payment plans. In many cases, patients DO want to pay their bills but need to have options that accommodate the financial reality of their circumstances. Ensure that there is an online portal for convenience and send automated reminders that encourage payments without the expense of snail mail.

Dollars that are collected before services are rendered never cost health care organizations a penny, they don’t sit in A/R and never become bad debt. Coming out of Covid, there are care delays that have likely created pent up demand for orthopedic and oncology services. 81% of those patient would pursue care if they knew what their financial responsibility would be. Getting those patients back into clinics and making it consumer friendly are key.

Interested in learning more? The team at VisiQuate is focusing on how we can help hospitals optimize their revenue cycle management. Visit our Revenue Cycle Playbook for step-by-step plays to help you stay on top of the ever-changing landscape of healthcare revenue cycle, or contact us to schedule a demo.

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