Price Transparency

Rising medical debt, now a staggering $140 billion, is the largest source of debt for American families. A large portion of this is a direct result of surprise billing, with a third of insured adults saying they’ve received an unexpected bill in the previous two years. What’s no surprise, then, is that two-thirds of US adults worry about being able to afford these unanticipated medical bills. It’s a problem that concerns so many patients that it now has the attention and action of both state and federal governments. To help solve this problem, Congress signed the No Surprises Act into law. Experian Health can help your healthcare organization navigate the regulatory landscape  and implement solutions ranging from transparent, patient-friendly estimates to our all-new FREE No Surprises Act (NSA) Payer Alerts Portal.  The No Surprises Act, effective January 1st, 2022, aims to protect consumers from at least one contributor to the problem: unexpected bills for out-of-network care in emergency and non-emergency settings. Around a fifth of emergency claims and a sixth of in-network hospital stays include an out-of-network bill, often due to emergency or ancillary care. Since patients lack meaningful choices when it comes to choosing these unexpected services, they have no option but to pay up or face negative marks on their credit reports. Typically, while health plans cover some of the bills, patients will still be responsible for the remaining balances. Webinar Series: Unpacking The No Surprises Act and Q&A with an expert Industry expert Stanley Nachimson, Health IT Implementation Expert, recently hosted a series of webinars to help providers get up to speed on what they need to do to comply with the No Surprises Act. Learn about the Good Faith Estimate, how NSA will apply in different care settings, and more. By enforcing better price transparency and consumer protection, the new regulations will help to create better patient experiences and ensure that fewer bills are written off to bad debt. However, according to a recent survey conducted by Experian Health, only 72% of providers are familiar with the No Surprises Act. That’s not all - only 40% of respondents are moderately confident their organization will be able to solve for the No Surprises Act. Payers and providers must act now to ensure their processes are ready to comply with the changes. Experian Health is now offering a FREE comprehensive, updated list of No Surprises Act (NSA) payer policy alerts for United States hospitals, medical groups, and specialty healthcare service organizations. Tackling the price transparency problem with the No Surprises Act Healthcare pricing has been under the spotlight for a while, with several new regulatory measures introduced over the last few years. The new Act, which was signed into law under the Consolidated Appropriations Act of 2021, builds on previous federal actions to empower patients by giving them greater access to healthcare cost information. Come January 2022, balance billing will no longer be permitted for out-of-network emergency services, out-of-network air ambulance services, and out-of-network non-emergency services provided at in-network facilities. Insurers must cover emergency services without any prior authorization, regardless of whether the provider is within the health plan’s network, and patients should expect to pay the same as in-network services. The Act requires both providers and health plans to help patients access healthcare pricing information, and providers must provide consumers with tools to get better price estimates, including a “Good Faith Estimate” covering all relevant codes and charges. The Act sets out a process for health plans to reimburse providers and an arbitration path in the event of disagreement. Summary of provisions in the No Surprises Act: Protects patients from receiving surprise medical bills resulting from gaps in coverage for emergency services and certain services provided by out-of-network facilities Holds patients liable only for their in-network cost-sharing amounts, and requires that the patient’s share cannot exceed in-network rates without patient consent Provides guidance for how providers and insurers can negotiate fair reimbursement for out-of-network services Includes the requirements that providers submit Good Faith Estimates to payers and that payers utilize those estimates to create and provide Advance Explanation of Benefits to members. However, enforcement of this requirement has been delayed until more guidance can be provided related to standards for the transmission of these files (as of October 2021) What do providers need to do now to prepare? Creating a “no surprises” billing experience will require payers and providers to make major process changes. Roger Johnson, VP of Payer Solutions at Experian Health, says, “The new regulations require the industry to innovate significantly in a very short timeframe. Determining network status is a huge challenge for providers, as is engaging patients electronically pre-service. There will also be challenges in tracking and submitting consent forms, producing Good Faith Estimates, applying appropriate cost-sharing, billing, payment reconciliation, and the new dispute resolution process.” See what Roger had to say in our Interview with the Expert: CMS has provided a list of documents and requirements for patient notices. These include: A statement that the provider or facility is OON (if that is the case) An itemized, good faith estimate of the cost of care Information on prior authorization and utilization management limitations The notice must be in a format the patient can understand and is accessible (i.e., preferred language and apart from other documents). A variety of model forms and notices are available on the CMS “Overview of Rules and Fact Sheets” page: Standard notice & consent forms for nonparticipating providers & emergency facilities regarding consumer consent on balance billing protections: Download the Surprise Billing Protection Form Model disclosure notice on patient protections against surprise billing for providers, facilities, health plans and insurers: Download Patient Rights & Protections Against Surprise Medical Bills Paperwork Reduction Act (PRA) model notices and information collection requirements for the Federal Independent Dispute Resolution Process: Download Model Notices and Information Requirements Paperwork Reduction Act (PRA) model notices and information collection requirements for the good-faith estimate and patient-provider payment dispute resolution Download Model Notices and Information Requirements Additionally, The Department of Labor published a Model Notice link on its No Surprises Act overview page. Experian Health is engaging with industry partners to clarify the regulations and collaborate with clients to adapt workflows for a smooth transition. Find out more in our on-demand webinar. What price transparency tools are available for healthcare organizations?  In the meantime, various price transparency tools exist to help providers meet ongoing regulatory requirements and create a better patient experience with easy-to-understand cost breakdowns. For example: Patient Payment Estimates give patients clear and accurate estimates of authorized services before, or at, the point-of-service, so they feel more in control of their financial obligations. With a user-friendly interface, the tool helps patients plan and pay their bills – while directing them to appropriate financial assistance options. And because it’s automated, hospital staff will no longer need to manually update price lists. For providers, this tool can create an on-demand Good Faith Estimate using out-of-network benefits. Patient Financial Advisor is a text-to-mobile service that lets patients see their estimated costs of care before they come to the hospital. This solution provides a full breakdown of the procedures, as well as a total estimated amount based on in-network benefits. Registration Accelerator has the ability to collect provider forms and return them back to the client’s document imaging system. ClaimSource can identify claims that are at risk, prior to being submitted to payers. Claim Scrubber can identify claims at risk from various angles, such as: Non-Network payers Non-participating providers Services provided without an approved authorization Services provided outside of the approved authorization criteria While regulatory change can seem daunting, price transparency is already trending in the right direction. Our second State of Patient Access survey indicated that both patients and providers want more price transparency. Nine out of ten providers told us they agree that price transparency improves the customer experience and increases the likelihood that patient bills are paid. The regulations may be a catalyst for change, but making it easier for patients to understand and pay their bills continues to pick up momentum. That’s good news for patients’ wallets and for providers’ bottom lines. Download our on-demand webinar, "Unpacking the No Surprises Act," to learn more about how the new regulation will impact patient and provider workflows.

COVID-19 changed every aspect of the patient journey – placing unprecedented demands on the healthcare system and accelerating the need for digital transformation industry-wide. Telehealth, touchless engagement, and self-service scheduling became the new normal; however, this created new stress on operations, administration, and finance. While this new normal comes with many challenges, data and digital tools have created greater accessibility, engagement, transparency, and control for patients and providers. In this blog, we examine COVID-19’s impact on the patient journey and explore the digital tools and data that are helping the healthcare industry recover and thrive. To get more insights, read the full whitepaper here. COVID-19 strained the healthcare system more than ever before. To say that COVID-19 challenged the healthcare system is a massive understatement. Seven in 10 patients deferred or canceled treatments during the pandemic, causing disruptions to both revenue and patient engagement. Even behind the scenes, novel diagnostic codes and new sources of information—together with rising inpatient volume and government intervention—affected costs, billing and reimbursements at scale. Patient-provider relationships became much more complex. Many people moved, changed jobs and changed insurance during the pandemic. In fact, an estimated 40 million Americans lost work during the pandemic and just over half of all workers in North America plan to look for new work in 2021.  As a result, relationships between physicians and patients became disrupted. While re-engagement is critical for providing care, simply finding patients remains a challenge. The digital experience raised patient expectations. As consumers turned to technology to cope with changes, digital engagement increased in healthcare services and elevated consumer expectations. This trend began before the pandemic: A pre-COVID-19 AARP survey of older adults (50+) found that a majority would prefer to have their healthcare needs managed by a mix of medical professionals and technology. During the pandemic, patients used telehealth to access care from home, mobile registrations to avoid filling out paperwork in the waiting room and digital payment options that made paying bills simple and seamless. Now that patients have experienced telemedicine, self-service scheduling and easy digital payments, there is no going back. Expectations have changed permanently, and providers that don’t offer an updated patient experience may suffer by comparison. Opportunities for better outcomes: transforming the patient journey with digital transformation We looked at key parts of the patient journey where technology is helping healthcare providers engage and care for their patients successfully across the marketing, scheduling, registration, authorization, treatment, claims and payment. Here are a few strategic opportunities for providers to consider post-COVID: 1. Use smart data for better outcomes Third-party data is helping providers find and re-engage patients, deliver more holistic care and facilitate better financial outcomes. For example, integrating data on social determinants of health (SDOH), can provide physicians with a more holistic picture of non-medical factors that may influence medical outcomes, such as a patient’s socioeconomic status. SDOH data can also shine a light on a patient’s ability to pay, which in turn may inspire a wider range of payment options so that more patients can afford care, and more providers can avoid write-offs. 2. Continue using technology and automation for the recovery to come Using digital self-service applications for registration does more than just provide the patient-friendly option of completing paperwork at home (instead of the waiting room). It also eliminates the need for staff hours spent inputting information, reduces the potential for error, and improves efficiency. Advances in automation make it possible for providers to reduce the effort of manual tasks - like sorting through patient records from disparate sources to create a single, comprehensive patient file, or gathering the information necessary to revisit claims authorization for deferred care. Across the board, digitalization provides greater transparency, flexibility, and seamless experiences for patients and providers alike. 3. Clear the path for payments Going digital can help patients and providers better navigate the patient journey, especially when it comes to payments. As many as half of nonretired adults expect long-term financial effects as a result of the pandemic. This makes it more imperative than ever to improve and accelerate authorization, claims, and payment processes so that both patients and providers have a clearer understanding of how care will be paid for. Accurate patient estimates, coverage discovery, automated authorizations, and payments all play a role in creating a better financial experience going forward. Digital transformation gains traction as we look to the future Although the digital transformation was already underway before COVID-19, the pandemic has accelerated the need for data, automation, and self-service tools. Find out how Experian Health can help your organization meet the data challenges of the post-COVID-19 patient journey by downloading our white paper.

"93% of providers say creating a better patient experience remains a top priority, up 3% from last year." - Experian Health's State of Patient Access, June 2021 In November 2020, we surveyed patients and providers for their sentiments on how patient access changed because of the pandemic. During this time, patients welcomed the convenience and control that came with digital, contactless care. Providers knew they needed to improve their digital front door to withstand the financial impact of COVID-19, but implementation was difficult for many organizations. Six months on, and millions of immunized Americans later, the pandemic landscape shifted again. In June 2021, we revisited these questions to find out if patient and provider views have changed - in our State of Patient Access 2.0. Now, patients tell us they feel more confident about returning to facilities, though they still want the flexibility and convenience of digital scheduling, registration, and payment options. Providers feel a growing urgency to make sure online services are sufficiently agile enough to withstand any future surges in COVID-19 case numbers. The findings of the survey reveal four major opportunities to rethink how we “do” healthcare. By innovating and building on the digital advances made possible during the pandemic, providers can create better patient access experiences for the future. To start, providers should: 1. Match consumer expectations for convenient and flexible patient access Our recent survey shows that the pandemic has cemented consumer expectations around convenient access to care. Digital and remote channels for scheduling appointments, completing pre-registration, and making payments have become the new baseline in patient access. Nearly three quarters of patients told us they want to schedule their own appointments online. Providers know this: 93% say creating a better patient experience remains a top priority, up 3% from last year. Online self-scheduling can help providers continue to meet their patients’ demands for flexibility and convenient access to care. Patients can find, book and cancel appointments whenever and wherever they prefer. It’s also a win for providers, who can expect to see a drop in administration errors, no-shows, and denied claims. 2. Streamline prior authorizations as more patients return to care Interestingly, new data reveals that patients are less anxious about in-person care. In 2020, 40% of patients were uncomfortable coming into waiting rooms and seeing their doctor in person. Now, only 16% say they wouldn’t be comfortable in a waiting room. As more patients rush to reschedule deferred care, providers are faced with the challenging combination of higher patient volumes, patients jumping health plans as a result of job losses, and changing payer rules around prior authorizations and coverage checks. Automated pre-authorization and automated coverage checks can relieve the pressure, and help providers save time and resources. 3. Promote price transparency for fewer missed payments An encouraging piece of insight from our latest survey reveals that far fewer patients say they’ve been surprised by their final medical bill. In 2020, more than 50% received a final figure that differed significantly from estimates. Six months later, that figure has dropped to just 14%. Price transparency remains important, and the gap between estimated and final costs seems to be closing. More providers are offering patient billing estimates, with 9 in 10 agreeing that accurate estimates increase the chance of bills being paid on time. Many are also giving patients more options to pay bills earlier in the journey, which has helped to minimize the risk of late and missed payments. Easy and accessible digital options are featured heavily in acquisition and retention plans, and can help drive financial recovery. 4. Tighten up data strategies with better security, quality and insights While our first survey revealed that the sudden shift to digital-first patient access was a shock to the system for many providers, the second study shows that both patients and providers are settling into digital ways of working. But as these digital services become the new baseline, providers must make sure their data strategies are fit for purpose, and prioritize data security, quality and insights. Moving forward, a multi-layered approach will help providers authenticate and secure patient identities. When these identities are enriched with information about how patients are affected by the social determinants of health, providers will be better positioned to offer personalized patient access experiences and support marginalized groups. The future of healthcare is digital. Is your organization prepared? It’s clear from our recent survey that the digital trends that emerged in 2020 are set to continue throughout 2021 and beyond. Download the State of Patient Access 2.0 white paper to get the full survey results and explore how data and digitalization can power a 24/7 patient access experience in your healthcare organization.

The pandemic dominated healthcare in 2020, but it won’t be recognized as a reason to delay complying with CMS’ price transparency mandate, which went into effect on Jan. 1, 2021. A recent study conducted by HealthAffairs indicated that 65 of the 100 largest hospitals in America had not complied as of February 2021. And new reports from CMS suggest $300 daily fines will follow if CMS warning letters have no impact, in addition to the possible public exposure of facilities failing to be compliant. There are a number of reasons why price transparency has generated so much attention – both before and during the COVID pandemic. Consumer advocates point to other transactional experiences, such as auto and home purchases, where understanding the price is complicated, but achieved. There’s been a lot of research on price transparency’s impact on patients, as well; helping consumers understand healthcare billing reduces the stress of their financial experiences. Transparent pricing makes sense in many cases for providers, too. They may benefit from patients being able to plan for the costs of care, which can result in fewer missed payments and write-offs. For these reasons and others, price transparency has been a hot topic for the last few years. The Centers for Medicare and Medicaid Services (CMS) final rule on price transparency became effective on January 1, 2021, requiring hospitals to give patients clear information about their medical costs, including a list of charges for the hospital’s 300 most shoppable services, so patients can make informed decisions. Payers are expected to provide similar pricing information beginning January 1, 2022. The spotlight on healthcare pricing seems unlikely to dim any time soon. What does this mean for providers and payers? Price transparency is here to stay There were legal challenges made against the price transparency final rule, questioning federal authority and invoking constitutional rights violations, but the DC Circuit Court dismissed the claims in December 2020. Arguments against the current mandate are not limited to disputing legal authority, suggesting that government should not interfere with private sector pricing – and that complex pricing information could create the opposite effect of confusing consumers. In fact, many providers and payers voice support for price transparency, but not as put forward by the final rule. Despite this, consumer demand for pricing clarity before delivery of services continues to grow and current government regulation is the most far-reaching attempt so far to remedy this. A few state legislatures are moving forward with their own regulations, which could prompt more local collaborations between providers and payers to clarify out-of-pocket cost estimates. Achieving the level of transparency that CMS and consumer groups hope for will be challenging, but attempts to find common ground are growing. What will price transparency look like under the Biden Administration? Since President Biden entered the White House, the trend towards transparent pricing has continued. Provider compliance has been slow – many pointing to 12 months of battling COVID as the primary reason – prompting legislative pressure to step up audits and penalties. CMS has already started issuing noncompliance warning letters and, while it may modify the ruling under a new administration, there’s no sign of any plans to reverse the policy. Consumer action groups have voiced concerns that the regulation falls short, citing the difficulty a consumer may have trying to find pricing at provider web sites. Other consumers are limited to payer-negotiated rates and have little choice but to stick with their current providers. Making information available is likely an early step toward what price transparency will ultimately look like, but making that information easy to find, understand and act on is what consumers value – and what many providers and payers say they want to provide in a more customized, less one-size-fits-all application. A marketing strategy for price transparency As patients bear more responsibility for healthcare costs, they’ve come to expect a consumer experience that affords them greater control and choice. A Pioneer Institute study found that 70% of healthcare consumers want to see pricing information before undergoing a medical procedure. Actively communicating a commitment to price transparency can be a powerful marketing strategy to attract and retain loyal consumers. Not surprisingly, this messaging resonates more with user-friendly tools to guide patients through their financial journey and make sense of charges. Many providers believe they’re complying with the final rule but may actually be vulnerable to penalties because their pricing files are in user-unfriendly formats. A web-based pricing tool can help solve for this by offering patients accurate estimates and recommended payment plans before or at the point of service. Similarly, a text-to-mobile tool, such as Patient Financial Advisor, can send automated text messages to patients with personalized estimates and bills. Keeping an eye on healthcare price transparency More tools are now available to help patients make sense of their billing and it’s becoming easier for providers and payers to create a patient financial experience that’s supportive from the start. Not only will this help patients understand their cost of care (and with that understanding likely comes better collections performance), it’ll help reduce the risk of uncompensated care ¬– and avoid penalties as the final rule takes root. The Biden Administration’s focus on consumer-friendly healthcare services will likely keep price transparency at the forefront. What that looks like over the next few years depends on regulatory and market forces, but providers and payers alike will benefit from offering solutions that make sense for their organizations and patient populations. Find out how Experian Health’s price transparency tools could help your organization with the transition.

Will handshakes become a thing of the past? Will face masks become a regular feature of flu season? Will home-working remain popular, even after workplaces re-open? COVID-19 forced some abrupt behavior changes that challenged existing cultural norms, but as the pandemic subsides, how many of these adaptations will survive?   For healthcare executives, the return to on-site medical visits raises similar questions. Healthcare consumers were already expressing an appetite for more convenience and control, and the pandemic accelerated the use of digital solutions for everything from patient access to telehealth. Being able to book appointments, complete pre-registration forms and make payments online is the new baseline.   As patient volumes start to increase, hospitals and physician groups shouldn’t take their foot off the gas with digitalization, particularly in patient intake, which doesn’t have to involve in-person contact. There’s an opportunity now to learn from what’s worked well over the last year and cement the pandemic’s digital legacy.   What does the new normal look like in patient intake? Getting back to basics with convenience and compassion Once crisis mode has passed, providers can refocus their efforts on the building blocks of an optimal health service: high quality care and a convenient and compassionate patient experience. After the uncertainty and loss of control over the last year, patients want autonomy and choice. Initiating a smooth patient journey through online pre-registration, patient portals, virtual waiting rooms and digital scheduling can contribute to this.   Many will be happy to say goodbye to piles of paper forms and long waits in the waiting room. But any digital strategy must also support those with limited access to devices and broadband or limited digital literacy. Liz Serie, Director of Product Management at Experian Health, says:   “The goal is to give patients the same exceptional experience and care, regardless of when or how they complete patient intake. Using the same tools that we know our patients are already comfortable with will help to ensure an inclusive approach.”   Digital technology can support a multichannel approach, for example, using automated dialers to make phone calls where mobile apps aren’t an option, or using patient data to segment individuals according to contact preferences. Re-engaging hesitant patients The CDC reported in September 2020 that around 40% of adults delayed care due to the pandemic. While more recent data suggests fewer patients are deferring care, some experts worry that patient volumes won’t return to normal until 2022. How can providers ease the return to care?   Online health portals were helpful in keeping people out of facilities during the pandemic – can they now serve a different purpose in reminding patients to come in for check-ups?   Patients will need clear information about what protocols to follow during patient intake and what to expect from virtual waiting rooms, as well as reassurance that the experience will be safe. Streamlining patient access with accurate data Unlocking the digital front door made logistical sense during the pandemic. It’s even more critical as patient volumes drive back up. Providers will want to review their protocols to be sure that speedy implementation has not left that door open to costly data errors. Is the right information being collected at the right time?   Consumers are looking for flexible and accurate appointment slots for self-scheduling, and they want their financial ducks in a row as soon as possible with quick authorizations and coverage checks. Getting data right first time makes for a smoother patient experience, more efficient staff workflows and fewer claim denials down the line. Preparing for an uncertain future Looking ahead, patient intake protocols will need to be flexible enough to adapt to changing patient needs, particularly if there are further waves of the pandemic. Digital solutions can help providers prepare for the unexpected and shift from a reactive response in a crisis to a proactive step towards the future.   For many providers, future-proofing the patient intake experience is also an important remedy to the financial losses suffered during the pandemic. Digital solutions built on accurate data, consumer needs, accessible information can protect against further revenue loss by giving patients reliable ways to access and pay for care, no matter what the future holds.   Medicine is built on in-person care, but we don’t need to be face-to-face to fill out forms. Patient intake is one area where “the old way” doesn’t have to return. Find out more about how your organization can build on the pandemic’s digital legacy and create a leading patient intake experience.

Providers know they need to improve their digital front door to withstand the financial impact of COVID-19, but change can feel risky, especially with so much uncertainty. Experian Health’s recent patient access survey offers a glimpse of what patients hope the digital front door will look like in 2021 and beyond. But what do providers see for the future of patient access? And are those views aligned? Providers that offer the most accessible patient access solutions in a post-pandemic world will secure greater patient satisfaction and loyalty.

How has the pandemic affected consumer attitudes around patient access? What do consumers want when it comes to accessing care? These are the questions providers must answer if they are to survive the pandemic and lay the groundwork for future financial success. Experian Health’s recent patient access survey offers a glimpse of what patients hope the digital front door will look like in 2021 and beyond. Wherever you are in the digital patient access journey, there's an opportunity to improve the experience for patients to one that will not only survive the tumult of the pandemic, but also thrive in the years ahead.

Experian Health products referenced in this blog post: Patient Engagement Solutions Patient Scheduling Precise ID Patient Payment Estimates Patient Payment Solutions To access more insights and trends, download the entire white paper:  How has the pandemic affected consumer attitudes toward patient access? What kind of digital experience do consumers expect from their healthcare provider in 2021? Are patients and providers on the same page when it comes to self-service in the healthcare journey? Providers must answer these questions if they are to improve their digital front door, boost patient loyalty and withstand the financial impact of COVID-19. While we know that a satisfying patient access experience translates to a stronger revenue cycle, change can feel risky without knowing what consumers really want. Experian Health surveyed hundreds of healthcare consumers and providers to find out what each expects from patient access in 2021, and uncovered opportunities for providers to lay the groundwork for future financial success. Survey findings: 4 revenue-boosting opportunities for patient access in 2021 1. More control and convenience for consumers Nearly eight in ten consumer survey respondents want to be able to schedule their own appointments, at any time of day or night, from their home or mobile device. They can already order groceries and view their bank accounts this way – and they want the same level of control and convenience when managing the non-clinical aspects of their healthcare. Digital patient engagement solutions allow providers to offer consumers the flexibility and accessibility they crave. Patients can schedule appointments online, complete registration from home and pay bills from a mobile device. Convenience also delivers health benefits: no-shows are less likely, and patients find it easier to adhere to care plans. And while COVID-19 remains a concern, self-service options minimize face-to-face contact, keeping staff and patients safe. Automating patient access even contributes to better collection rates, for example, by reducing errors that can lead to denied claims. 2. But don’t deliver convenience at the expense of safety and security Patients want convenience, but they also want their data to be kept safe. More than half of consumers surveyed, particularly the younger age groups, say they worry about security when accessing their personal details online. Security can be challenging for providers: they need multi-layered solutions that can adapt to security threats that evolve with ever-increasing complexity, without creating cumbersome log-in processes for patients. But with the right technology, providers can  safeguard patient data with confidence. Experian Health’s patient portal security tools use leading-edge identity proofing, risk-based authentication and knowledge-based questions to reliably verify patient identities. Patients can book appointments, register for care or view their health information. Calls to IT support are likely to drop too, saving staff and patients valuable time. 3. Contactless care requirements are driving long term, systemic change While many of these changes were already simmering in the background, the pandemic has turned up the heat and accelerated the need for contactless care. Will this be a long-term trend? Both patients and providers believe self-service technology is here to stay and seven in ten providers surveyed say they don’t expect patients to feel comfortable in waiting rooms until at least summer 2021. While face-to-face care will always be important, it seems likely that a digital front door will become the default to make the non-clinical portion of the healthcare journey easier and quicker for everyone. “As providers expand the use of patient portals, there is a huge opportunity to demonstrate the true value of virtual care – and transform healthcare for the long-term." - Tom Cox, general manager, head of product, Experian Health 4. The financial conversation between consumers and providers must be based on trust, transparency and empathy When the final bill bears no resemblance to initial estimates, patients feel frustrated and misled. With deductibles and out-of-pocket expenses on the rise, patients are demanding simple and clear pricing information so they can plan accordingly. Providers that offer consumers transparency, understanding, control and convenience when managing their financial responsibilities are going to have the competitive edge. Providers can achieve this with clear, upfront and accurate pricing estimates to help patients understand their financial obligations before their visit. Next, support to check coverage and advice on tailored payment plans will provide patients with as many tools as possible as they plan to meet those obligations. Experian Health’s Patient Payment Solutions can check for patient coverage, identify a payment plan(s) that suits a patient’s individual situation, and then make it easy to pay via a mobile device. Future provider revenue hinges on investment in digital healthcare. A welcoming, convenient and secure digital front door translates to patient loyalty, which in turn can mitigate losses in challenging times. Wherever are in digital patient access journey, there’s an opportunity to improve the experience for patients and build a revenue cycle that not only survives the tumult of the pandemic, but also thrives in the years ahead.

As 2020 draws to a close and headlines hint that the end might finally be in sight for the pandemic, the healthcare industry is considering COVID-19’s legacy. The sudden shift to contactless care, financial consequences of widespread social distancing measures and changing expectations of the patient experience have upended the world of healthcare and health IT – but which changes are here to stay? And what do these changes mean for the patient experience in 2021? We asked several leaders across Experian Health for their predictions in the areas of patient access, collections, and identity management, and here is a preview of what they had to say: “Patients will choose providers that give them control over their healthcare experience” Patients have more opportunity today than ever before to manage their healthcare experience from the comfort of their own home, whether that be through patient portals, online self-scheduling and registration or online payment tools. As lockdowns and social distancing prevented patients from presenting in person, providers were forced to offer patients with more options for self-service. Unsurprisingly, this was a move a lot of patients have been waiting for and many welcomed this new technology with open arms. Jason Kressel, senior vice president of consumer products and analytics at Experian Health, expects that, as patients become more accustomed to this level of self-service, more than half of consumers will change providers in favor of one that offers premium digital healthcare services: “Providers who can meet patients where they are—through web-based services and via their mobile devices—will have the most success with retaining and attracting patients.” Online self-scheduling can put patients in the driver seat while also avoiding unnecessary contact while many remain cautious about on-site visits. With access issues removed, the patient experience will improve, in turn improving health outcomes (and providers’ bottom lines!). “With hospital finances on shaky ground, collections will be a top priority for survival” As COVID-related unemployment leads to an unstable insurance landscape, many providers are worried about maintaining effective collections processes, and they cannot afford to spend time chasing payments. Guarding against uncompensated care and tightening up the collections process will be essential. Automated collections software can help collections teams focus their efforts on patients who are most likely to pay, while also helping patients manage their financial obligations with as little stress as possible. Providers can also quickly determine which patients qualify for financial assistance, helping them get them on the right payment pathway for their circumstance without delay. Not only will this provide a much better patient financial experience, it’ll prevent “lost coverage” and allow providers to collect a larger portion of dollars owed. “The surge in portal usage means providers need to watch out for fraudsters” What does the rapid growth in portal uptake mean for data security? The speedy rollout of telehealth and other digital services has exposed security concerns for many providers, who fear a rise in fraudulent activity in 2021 as cybercriminals sniff out opportunities to steal patient data. To protect patient information and avoid costly reputational damage, providers must adopt more sophisticated identity management solutions. By combining cutting edge identity proofing, risk-based authentication and knowledge-based questions, providers can more easily verify a patient’s identity when they log on to their portal, greatly eliminating the risk of fraud. Interested in learning more about other trends that could affect the patient experience moving forward?