Tag: self-pay collections

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.

For many patients, the unknown cost of unexpected care is a source of anxiety: two-thirds of Americans are “very worried” or “somewhat worried” about being able to cover unexpected medical bills. No wonder, when around 56% say they wouldn’t be able to afford an unexpected bill over $1,000. In cases where insurance doesn’t cover the entirety of the bill, responsibility for paying the balance falls to the patient. The lack of price transparency leads to confusion and stress for patients, and unnecessary administrative costs for providers, who are left to chase payments from growing numbers of self-pay patients. Moving towards more transparent pricing Traditionally, patient billing has been calculated at the end of the revenue cycle, after insurance adjustments have been made. In recent months, a push for meaningful price transparency is emerging as a result of consumer demands about the cost of care, pressure from governing bodies, and bipartisan support for a legislative solution to surprise billing. In response, healthcare organizations are increasingly looking to move patient billing to the front of the revenue cycle, to give consumers greater clarity about what to expect when their bill arrives. Estimating patient liability is far from simple. It calls on front office staff to make complicated calculations based on insurance benefits, charges, contractual adjustments and provider discounts. If staff are doing this manually, they may find themselves using outdated pricing lists that don’t include current insurance information, rates and discounts. So how should providers ensure their front office staff have the right tools in place to give accurate, personalized estimates for each patient? Data-driven technology can help reduce surprise billing Data-driven technology that automates, simplifies, and unifies the revenue cycle can ensure timely communication on billing between healthcare providers and insurers. This means your front-office team can base estimates on accurate, up-to-date information. To reduce the risk of errors creeping in, price transparency and collection practices should be standardized across the enterprise. A pricing transparency tool eliminates the need for manually updated price lists and removes the guesswork that often leads to mistakes. It can also include reporting features that let you track potential and actual collections, so you have greater insight into the opportunities for revenue cycle optimization. Helping patients navigate the cost of care As patients bear more out of pocket payment responsibility, they expect a better consumer experience. Creating an optimal patient collections strategy and frictionless experience is ever more important. Full transparency calls for accurate and up to date pricing to be available to patients before they receive care, along with a detailed breakdown of what their insurer will cover. When they know what the difference is, they’ll know upfront how much they’re likely to need to pay. Additionally, clear and proactive communication around the billing process can help eliminate the shock factor, improve the patient collections process, and create a better patient financial experience all round. You could provide a text-to-mobile experience that delivers a text message with a secure link to the patient’s estimated bill. Or you might integrate a price transparency tool into your patient portal or mobile app, that lets patients see a personalized cost breakdown based on real-time pricing and benefit information, alongside methods for secure payment. A price transparency tool can also help you gather insights into a patient’s financial situation and propensity to pay, so you can optimize your collection strategies from the start and get them onto the right program. El Camino Hospital in California set an organizational objective to improve price transparency. Terri Manifesto, Senior Director (Revenue Cycle) says: “We decided to do a soft launch of a patient estimator tool, and the very next day, even without advertising it yet, our patients found the tool on the website and started using it. The feedback was excellent. We’re providing a lot more estimates than we could before because it’s 24/7 and patients can use it on their mobile device, their laptop or their desktop. Some advice I’d give other hospitals is to think of the patient when you’re deciding what to do to best communicate your prices. What would the patient want?” Working with a partner such as Experian Health lets you combine industry-leading technical expertise and payment tools with your own knowledge of your patients, so you can create the best payment experience for your consumers. Using data-driven technology, you can work to eliminate the pain of surprise bills and promote price transparency, resulting in greater revenue opportunities and customer loyalty.

As of January 1, 2019, thousands of hospitals in the U.S. are being required to post an online list of the cost of their services due to a new requirement by the Centers for Medicare & Medicaid Services (CMS). However, amid growing confusion about which fields are required or what format the list of standard services needs to be in, many health systems feel this new law will only create confusion among patients. One health system described the new requirements as, “It would be like walking into a car dealership looking at a new car, asking the salesman how much the car was going to cost and having them hand you the parts catalog. Obviously, when you have the parts catalog, you don't know what parts are in your car or which ones you're going to use or how much labor is going to go into making the car." While posting the list of prices is required by CMS, some health systems have invested in the needed technology to make it easy for patients to shop online for care. For example, in an interview with Modern Healthcare, El Camino Hospital explains they “launched a consumer self-service tool in May 2017, after about a year of development work with Experian Health. Since then, more than 3,000 people have visited the hospital's website, selected one or more of about 90 medical or surgical services they were interested in, entered their insurance information, and received an instant out-of-pocket cost estimate the hospital claims is 95% to 99% accurate.” Health systems like El Camino Hospital know that patients want to avoid costly surprises, and they should be able to understand their financial obligations upfront, including deductibles and copays. In fact, McKinsey research found nearly three-quarters of participants were worried about healthcare expenditures. Legislative help The new CMS requirement is only one of a few initiatives in the works from a legislative standpoint. In an effort to help patients, some members of Congress are trying to bring attention to the topic. A bipartisan group of U.S. senators in 2018 wrote a letter to healthcare stakeholders and experts requesting information in an effort to learn more about price transparency as they considered possible legislation on the matter. Also in the letter, the senators cited the lack of state laws and regulations requiring healthcare providers to make that information available to patients. More than 40 states were cited by the Catalyst for Payment Reform and the Health Care Incentives Improvement Initiative in 2016 because they were deficient in healthcare transparency legislation. And that same report found that some patients were paying thousands of dollars more than others for the same procedures, depending which healthcare provider they used. Alleviating patient stress Transparency in billing creates more satisfied patients because they know how much they will be paying for services, which makes it easier for them to budget. Going to the hospital is usually a stressful time for patients and their families. An easy way for healthcare providers to alleviate that stress is to help patients understand their costs upfront Most healthcare organizations already have the basic data they need to use automated technology to construct estimates for basic services, including claims data, real-time eligibility and benefits information, payer contracts and charge description master (CDM) information. Experian Health has the technology to help healthcare organizations convert this information into patient costs through Patient Estimates. This kind of transparency provides several benefits to both providers and patients. Online estimates published on healthcare provider websites give patients access to the information any time, including late at night and on weekends. And these estimates can be obtained confidentially, so patients who may be uncomfortable asking about certain procedures can find that information on their own. And that helps them be more relaxed about making appointments and scheduling treatments because they have confidence they won't face billing surprises. This feel-better result of having prices at their fingertips has a clear benefit for the healthcare providers as well. Patients are able to plan and pay for services, decreasing unpaid balances for hospitals and other healthcare providers. Ability to budget for healthcare costs Patients who know what to expect can budget wisely and actively take charge of their healthcare bills. They go in with their eyes open, which leads to improved revenue cycle management. In the end, both the patient and the hospital get what they want. With Congress and state legislatures looking at transparency in healthcare, providers can expect to see more of these rules. Healthcare organizations can get ahead of them with software like Experian Health's Patient Estimates. Healthcare consumers don't like surprises in their billing. Price transparency gives them the information and peace of mind they need to secure healthcare services and be assured that they know what they will be paying for them. Learn more about how Experian Health can help you achieve price transparency for your patients.  

Healthcare consumerism, which describes the ability of patients to shop around for the best value of care, has affected every aspect of the industry. Keeping up with those changes has challenged most institutions as patients become more savvy about healthcare costs and their choices.   But the freedom for patients to choose is only one side of the coin. The other is wrought with financial pain points that come with making the traditional billing model fit the new healthcare consumerism. For instance, organizations have to give patients precise cost estimates, but when patients change insurance coverage or companies change their policies and practices, providers struggle to keep those estimates accurate.   And patients who are hit with unexpected costs after they’ve received treatment are less likely to be able pay their bills. Hospitals and providers suffer from uncollected bills, which is compounded by claims denials.   Fortunately, the idea of healthcare consumerism inherently provides the solution to the pain. Emulating consumerism that's present in other industries, such as retail, means offering accurate and transparent pricing, eliminating uncertainty, and offering patients convenient and comprehensive financial options. Like other industries, healthcare already has a wealth of IT tools to make that possible.   Headaches for patients and providers   Simplifying financial pain points requires one significant change — hospitals and providers must deliver clear, simple information about what factors into their pricing. The first step is ensuring your system can keep up with the constantly changing details of insurance policies, supplier contracts, and everything else that affects those costs.   An automated IT solution can collect up-to-date insurance data, claims history, a patient’s financial situation, your organization’s price, and more before generating an estimate. When this data changes, estimates are no longer accurate, which is why healthcare pricing is so complicated. Therefore, tracking them and updating your system automatically can make it easier.   Most of the industry already uses analytics to some degree. Combined with automated financial data-gathering tools, those analytics can help organizations identify patients who are financially at risk and might qualify for additional funding options. Along with clear and accurate estimates, patients highly value a provider that cares enough to offer affordable financing options.   Alleviating those pain points   Keeping up with policy and other financial changes as quickly as they occur makes healthcare consumerism as beneficial for hospitals and providers as it is for patients. For example, Rocky Mountain Cancer Centers was able to reduce claims denials by 27 percent after implementing payer alerts and patient estimate solutions.   The same strategy helped the College of Medicine at Baylor University collect nearly $4.2 million in underpaid contracts, which it would have missed otherwise. Both organizations have also significantly boosted patient satisfaction with their financial processes, which has led to more positive experiences and reviews.   You can also alleviate financial pain points for patients and your organization by seeing healthcare consumerism as an opportunity instead of a burden. Patients demand the same level of cost transparency and certainty from every other industry. Healthcare organizations now have the incentive (and the means) to prove that they can offer the same level of service.

When was the last time you tried a new restaurant without reading at least one Yelp review beforehand? If you’re anything like the majority of American consumers, the answer is just about never. We live in an experience-driven world, after all, and whether you’re grabbing a bite to eat or trying out a new coffee shop, reviews are a great way to set expectations. But do patient reviews operate in the same way when it comes to hospitals? The answer is a resounding yes. Research shows that higher online ratings correlate with previously established metrics for evaluating hospitals, such as lower potentially preventable readmission rates. When it comes to overall satisfaction, patients are extremely perceptive, and they’re unafraid to share their opinions — good and bad. Yet Vanguard Communications found that about two-thirds of Yelp reviewers gave the top 20 hospitals rated by the U.S. News and World Report either a mediocre or poor rating. So where is the disconnect? One explanation might be that the areas assessed by U.S. News are too narrow. For instance, a hospital might rank highly for a certain specialty, bumping up its overall rating, but at the same time, its bill-pay system could be severely lacking, souring patients’ perception of the organization. Individual hospitals have the ability to assess all aspects of patient care — way beyond the scope of a top-20 list. The onus is on you to identify areas of improvement, and the best way to uncover hidden patient pain points is feedback.  And those pain points are more than just the bedside care received, but are often related on the financial experience. Creating a better experience At Experian Health, we don't focus on tackling every issue in healthcare; one of our specialties is helping healthcare organizations process and collect payment. However, that specific aspect of healthcare has a significant impact on overall patient satisfaction. In a recent study, Experian Health found the highest amount of opportunity for improvement is around the patient financial experience, which includes things like price transparency, understanding one’s ability for health payments, as well as options to pay for care. When it's easier for patients to pay their bills, they rate hospitals higher. Unfortunately, the first big obstacle in bill-pay is that patients often don’t understand what they’re paying for. Even if the quality of care was excellent, when a patient is unsure how much he or she owes, it’s all too easy to get frustrated and give a poor review. El Camino Hospital, a nonprofit hospital located in Mountain View, California, saw this problem play out with its own patients and, in response, made price transparency a major priority. Experian Health teamed up with El Camino to address this pain point. We debuted a self-service portal, allowing patients to access and manage a greater amount of data while still making account management, e-payment, eligibility, estimates, and billing information available. The most exciting element of the portal for patients and administrators alike was the addition of the patient price estimator, which gives instant estimates on a wide variety of procedures. The response to this tool was so positive that patients immediately began using it, even before El Camino promoted it. There was still room for improvement, though, so we worked to gather more patient feedback by incorporating a feedback survey into the portal. As surveys and comments rolled in, we discovered that patients were looking for a wider variety of services in the price estimator, so we’re now expanding the options. This consistent, patient-centered approach has shown tremendous benefits already. For instance, because availability to the portal is on demand, patients no longer need to directly contact the hospital for estimates, which typically results in a 24-hour waiting period. Because the call volume has greatly reduced, El Camino is now able to provide far more estimates in far less time. While El Camino Hospital's portal implementation is still in its early phases, other hospitals have seen impressive results with similar systems over a longer period of time. At Cincinnati Children's Hospital Medical Center, for example, they worked with Experian Health to revamp their online patient portal to make it more attractive and easier for patients to use. After the launch of their revised portal, online payments increased from $200,000 to $800,000, and patient billing satisfaction dramatically increased, as enrollment in their billing portal jumped from 900 to more than 45,000 families in a single year. The medical center’s patients now use the portal to ask questions of their healthcare providers, change on-file insurance information, and schedule or revise appointments. These features also reduce customer service phone calls and other related costs. The 3 steps of the patient feedback process When hospitals empower patients with access to their individual data and listen to their feedback, everyone wins. Patient feedback is essential at every level of implementing a new service to guarantee maximum efficiency. A successful patient feedback process includes these three steps: 1. Identify where feedback is needed. You don't need to harass patients for feedback on every single aspect of their hospital experience. Instead, look at which services would most benefit from patient insight; then, deploy surveys in those areas. Gathering feedback on high-volume services should be a priority simply because they affect the highest number of patients. Similarly, services that routinely trip patients up can only be clarified by directly asking patients what’s causing problems. At El Camino Hospital, creating the charge description master (CDM) was the first step in identifying where feedback was necessary. The list provided a convenient overview, so hospital administrators could easily pick out which services were high-volume or problematic and address them immediately. Whatever the method, pinpointing the services that are particularly troublesome for patients proves much more effective than trying to elevate the entire experience with no direction. 2. Make it multichannel. Feedback is often subject to selection bias, meaning a customer is more likely to write a Yelp review when he or she is either extremely pleased or extremely angry. Offering people several options for providing feedback increases the chances that you'll get a good sample size. You can gather patient feedback via polls using various methods, including text message, email, phone, and paper mail. El Camino Hospital chose to add an SMS feature, building a feedback function on its desktop interface while continuing to field phone calls regarding more complex issues. Its choice proved rewarding, and patient feedback rolled in. Limiting your feedback channels limits the amount and type of feedback you receive, so the more options that are available to patients, the more likely they will be to share their opinions and suggestions. 3. Identify patients who need help and offer it. Patient feedback is only valuable if you act on it. Once you’ve identified specific problems, reach out and offer a solution to patients who expressed concerns. In conjunction with increasing transparency, El Camino Hospital set a goal to identify and assist at-risk patient accounts. After gathering feedback and information on these accounts, El Camino integrated a medical billing fundraiser to lend a helping hand. From there, it created alerts for other at-risk accounts to spread the impact of the fundraiser. By responding to feedback, hospitals can respond to concerns before they become more serious problems, as well as anticipate patients’. If one patient encounters a problem, it's likely that several more will encounter the same issue — if they haven’t already. If hospitals aren't listening to their patients, they’re missing valuable insight into their problems and limiting their scope of improvement.

Providers can improve the customer experience and bottom line with the power of data and analytics. Introduction In an increasingly competitive and consumer-driven healthcare marketplace, it’s no surprise that providers are working harder to acquire and retain customers. Higher out-of-pocket expenses combined with more choice and control in when and where consumers receive care are driving more retail-like shopping behavior. As a result, healthcare organizations are looking for ways to slow or stop customer churn, drive audience engagement, and redefine how they interact with their customers instead of seeing them through a clinical transactional lens. Providers understand that they must deliver a positive overall experience to maintain a favorable brand in the community and earn customer loyalty, key factors in maintaining their financial solvency. While there are many facets to consider in providing customers a great experience during their healthcare journey, there hasn’t been much attention paid to the intersection between the clinical and financial sides of this experience. According to findings from an Experian Health study among 1,000 consumers and select providers, the greatest pain points and opportunities for improvement around the complete customer healthcare journey center on the financial aspects, from shopping for health insurance to understanding medical bills. This means organizations that want to meet the new demands of consumerism in healthcare and improve the holistic customer experience must address the end-to-end revenue cycle. Typical consumer healthcare journey* *Consumers revealed 137 “jobs” or “needs” associated with their healthcare experience, with varied levels of importance, difficulty and satisfaction. Money matters give consumers high levels of discomfort Using a “jobs to be done” methodology, qualitative insights were gleaned as to the jobs, or microtasks and decisions, consumers associate with a healthcare journey. Despite the staggering number and complexity of different “jobs” consumers must undertake just to access the care they need, patients’ biggest dissatisfaction centers on the process of paying for their care. Of all the activities included in a consumer’s healthcare experience — from acquiring health insurance to making appointments with providers to receiving treatment — the top “pain points” relate to money matters. Specific issues for patients surveyed include: Understanding how much is owed for services and if the amount is a fair market price Making sure they have money available to pay for services Determining what financial support is available (e.g., a payment plan) Ensuring that what is owed to the provider is accurate Understanding the amount covered by their health insurance [click on image to enlarge]   Providers also feeling the sting from unpaid collections, lack of customer service   The most glaring opportunity for improvement in the patient experience comes early in the journey — price transparency. Patients are understandably confused about what their health insurance covers. They can’t always understand medical bills, and they have difficulty finding out how much their out-of-pocket charges will be and what payment options are available to them. Providers are also suffering — from unpaid collections, low customer satisfaction levels and an inability to address issues holistically. Here’s what providers had to say: We’re addressing the patient experience in one-off initiatives. Help us holistically improve the end-to-end patient journey. Providers said key impediments to progress include lack of clear and consistent prioritization, significant interoperability issues, and complicated organizational structures. They are frustrated by how hard it is to execute holistic changes efficiently. We need to measure our customer experience better. We want to standardize an approach that will drive progress and impactful change. Providers don’t have a clear path to move from customer experience as a concept to a measurable discipline. It’s a priority for them, but few are using a measurement system they feel is helping them understand and improve their patient experience. Patients are suffering, in part due to a lack of understanding of their charges. We want to set better expectations and make the charges and the value of our services easier to understand. Rising patient responsibility and the proliferation of high-deductible health plans drive the desire for full transparency in costs. Managing expectations at each step is crucial to providing the most accurate information to the patient. We’re not equipped to address customer acquisition and loyalty. Help us efficiently attract more consumers and keep them with us long-term. The focus has always been on healing people, with less attention to the business and marketing aspects of providing care. Providers need to focus efforts on acquisition and loyalty, but they’re generally understaffed and lack the skills to do so. There’s no doubt that healthcare organizations want to evolve and are thinking differently about how they deliver services and the value associated with those services. Ultimately, those that see driving customer engagement and redefining how they interact with their customers as a necessity, rather than a luxury, will succeed. Revenue cycle solutions for today’s consumerism environment    Where to start? Key areas that can be addressed in the healthcare financial journey include: Comprehensive data – One of the core components of a patient-centric revenue cycle begins with the ability to use reference data to address duplicate medical records, understand a patient’s propensity to pay and identify social determinants of health. Incorporating this type of outside data into the revenue cycle won’t just create better patient experiences from the moment patients begin interfacing with staff, it will also optimize revenue for health systems while enabling a revenue cycle that puts the patient at the center of care. Patient identification – As hospitals must now deal with hundreds of thousands of electronic patient records, spanning multiple systems and departments, the traditional technologies for managing patient information are no longer sufficient. Using sophisticated matching technology and outside data sources can improve patient identification and prevent duplicate or overlapping records that result in inappropriate care, redundant tests and medical errors — as well as improving data accuracy for clinical, administrative and quality improvement decision purposes. Insurance reconciliation – Organizations can use automated technology to monitor claims data, real-time eligibility and benefits information, payer contracts, and charge description master (CDM) information to ensure that payers are meeting their obligations fully and achieve accuracy and transparency in healthcare costs. Closing the gap in payer contracts and reimbursement allows organizations to focus on providing transparent cost estimates throughout every patient’s continuum of care and helps patients know their costs so they are better prepared to pay them. Price estimates – Providing accurate patient estimates is quickly becoming the norm for health organizations. But to ensure patient satisfaction rates are being met, health organizations need to empower patients with a frictionless financial experience. By incorporating credit data into the patient billing process, health organizations can enable a people-first product design to price transparency and collections that extends benefits to more people by understanding the unique financial needs of each patient. Self-service portals – One way to engage patients is with an online and mobile-optimized experience that’s proactive, smooth and compassionate to empower patients to set up payment plans, apply for financial assistance, estimate the cost of care and review insurance benefits. Conclusion   With so much to consider when addressing the evolving patient/customer journey, providers are well-served to start by improving their customers’ financial experience. As the link between customer satisfaction and a health organization’s revenue continues to grow, efforts to create a better financial experience are crucial. Using comprehensive data and analytics to power the revenue cycle and customer relationship management initiatives will allow health systems to encompass the end-to-end customer journey to ensure streamlined operations, measure and improve performance with payers, and provide accurate insights into each unique customer and their needs. The key to establishing this customer-centric mindset is embracing the power of data and analytics. From offering access to automated, personalized tools to providing price estimates to informing about charity aid options and offering payment plans — all these innovations help customers feel they can make better decisions about their care and how to pay for it. The result is more satisfied customers and an improved bottom line for providers.

In a new whitepaper, Technology and Data-Driven Decisions Driving Best Practices for Patient Collections, Experian Health analyzes the results of two recently fielded surveys aimed at learning how organizations approach the process of obtaining payment from patients. The paper reviews both an HFMA-led survey and an Experian Health-facilitated one, discussing the current state of patient collections, as well as emerging best practices to improve performance. While knowing that organizations are working with varying degrees of success to offer more patient-friendly financial interactions, using technology and data to inform and drive patient engagement, Experian Health wanted to understand the best practices that organizations are using to elevate performance in patient collections. Our findings were published in this HFMA whitepaper which discuss the findings from these two research projects and validate best practices and offer unique insight into the successes and shortfalls of the patient financial experience at health organizations.

Manually cold-calling patients to remind them of upcoming appointments or of bills nearing a due date has never been an effective engagement strategy. On the contrary, such reactive tactics reduce engagement quality and can harm revenue cycles. It's important to remember that real connection empowers patients to be proactive in their care and improve their own outcomes, which encourages them to keep up with future appointments and medical payments. For modern healthcare organizations, maintaining this level of high engagement requires more than the automatic actions they’ve grown used to. Instead, the overall healthcare world needs more robust patient engagement to push forward and stay relevant with patients. Without this change, organizations are more likely to encounter skipped appointments, preventable readmissions, missed payments, revenue loss on several fronts, and poor patient outcomes. Fortunately, Experian Health offers a range of solutions that make it easy to engage patients in their care, improve patient outcomes, and create more profitable revenue cycle management (RCM) throughout an entire organization. Using patient engagement technology to improve care As previously mentioned in an Experian Health blog, patient portal technology — among others — is rewiring the technological landscape and capabilities in the physician and patient relationship. Portals are used for secure messaging by 41 percent of family practice physicians, and 35 percent of physicians also use them for patient education. This type of patient engagement technology culminates in our Patient Self-Service portal, which pools together data from our Patient Estimates, Patient Statements, and Coverage Discovery tools. The portal gives patients a single point of access to request estimates, pay bills, check financial assistance eligibility, and receive advice from doctors, nurses, and specialists. The above are just a few results from elevated, proactive patient engagement. Another perk is the portal’s unique ability to automatically populate patient-specific and payer-specific information into each estimate for optimal accuracy. This feature gives patients peace of mind by knowing what their exact out-of-pocket expenses amount to. When they receive a bill that matches the estimates they’ve been budgeting for, patients are more likely to adhere to payment obligations and return to a healthcare organization for future medical needs. This also makes it easier for an organization to collect payment at point of service and throughout the rest of the patient’s care continuum. Risk stratification for more successful revenue recovery For the first time in history, there is a growing convergence of powerful, internet-connected personal devices and massive amounts of analytical, social, financial, and behavioral data tied to individual patients. Experian Health’s timely patient engagement tools allow providers to tap into this convergence to revolutionize how they engage with patients at all points throughout their care. For example, by analyzing patient-specific financial information, this engagement technology can help providers identify when patients may benefit from financial assistance, especially for upcoming treatments. In turn, the provider can send the patient information about how to request for this type of assistance through an interactive portal with accurate estimates. To help reduce readmission rates for non-critical concerns, Experian Health’s tools can also help identify when patients may need unique, targeted engagement. For instance, patients with heart conditions can benefit from information regarding diet and lifestyle changes that improve cardiovascular health. These tools help providers determine the best type of content to send and the appropriate medium to send it through, such as email, text, or app notifications, according to the patient’s specific preferences. By working together with healthcare providers, Experian Health’s solutions combine highly personalized self-service with accurate price transparency and patient-risk stratification to proactively engage with patients. You, too, can be at the forefront of improving patient outcomes and RCM strategy effectiveness by understanding the changing healthcare environment. Utilizing tools, such as a patient portal and others, can position your organization to increase patient engagement and benefit from being a forward-facing healthcare provider.

Consumers love the ability to research and compare prices of products on the fly so they know upfront what they’re signing up for. They’ve come to expect this level of empowerment in every transaction. Yet in healthcare, that expectation is now a demand as patients shoulder increasingly higher out-of-pocket costs.   Patients are also wary of being surprised by exorbitant hospital bills months after care. As a precaution, they want to know how much of the costs they’ll be responsible for before they receive treatment. Additionally, it would also be nice to make payments and schedule appointments online without being put on hold for hours or dealing with confusing call centers.   Until now, healthcare providers have been more or less behind the times when it comes to integrating technology into everyday workflows. With this in mind, organizations need to make price transparency and self-service vital aspects of the care they provide, and they need the right technology to do it. Fortunately, benefits of self-service portals not only include price transparency, but also appointment scheduling. Experian Health’s range of tools, such as the Patient Self-Service portal, makes it easy for any healthcare provider to catch up and equip patients with the tools they need to be confident in their care and payments.   Advantages of self-service portals   Patient engagement is the cornerstone of quality care and clinical outcomes. However, it can be difficult when patients are prematurely frustrated because they already know they’ll be hit with higher than expected costs for their visit, tests, and treatments. As a solution, moving patient billing to the front of the revenue cycle eliminates that worry, making it the first step to build trust and improve patient engagement.   The next step is making administration simple and convenient for patients. Scheduling appointments, changing insurance or address information, and asking questions about their treatment shouldn’t be arduous processes. When patients can accomplish these tasks quickly and conveniently, they feel more satisfied with their chosen healthcare provider.   Empowering patients through information and engagement helps them manage their ailments, illnesses, or simple doctor visits more efficiently, which translates to fewer readmissions. Providers can also improve their cash flow by delivering accurate estimates and immediate balance notifications, rather than making patients wait up to 30 days for paper statements. In turn, patients and providers can both benefit from using a self-service portal because it improves virtually every aspect of healthcare administration.   Key benefits of self-service technology in an all-in-one portal   Experian Health’s Patient Self-Service portal makes it easier to keep patients informed and empowered, which not only improves the quality of their care, but also aids an organization’s financial health. For instance, manual scheduling alone takes one person or a team of full-time employees, which can be costly. On the other hand, in a self-service portal, patients interact directly with technology without the need for full-time human assistance.   The easy-to-use portal isn’t just about scheduling, though. Through the portal, patients can also check whether they qualify for financial assistance, receive support for presurgery planning and postsurgical follow-ups, and email questions to their medical team. Another helpful portal feature notifies patients about their possible qualification for charity care. If eligible, patients can avoid medical bankruptcy by setting up a crowdfunding page to help pay their bills.   Furthermore, the portal is accessible 24 hours a day, seven days a week. It's where the head of a household can review and update the entire family’s billing, account, and insurance information conveniently in one place. In addition, patients can receive a consolidated bill that's easy to understand and set up automatic payments so they know how to budget for future healthcare costs.   Combined with upfront price transparency – which is now a legal requirement in many states – the Patient Self-Service portal provides vital benefits for streamlining healthcare administration and engaging with patients on the level that they need and expect.