For the longest time, provider organizations centered their revenue cycle management strategies on commercial and government payers, but that has changed with the rise of high-deductible health plans. Patients are now in charge of more healthcare dollars than ever before, and as many patients still struggle to afford the high out-of-pocket costs associated with their health plans, rising deductibles continue to create financial risk for healthcare organizations.
Relying heavily on payments from patients is still a new ball game for healthcare organizations. Even those that offer exceptional clinical care still struggle with the shift to patient-as-payer. Before, provider organizations could ignore subpar patient collection rates in the past, as they were traditionally supported by reimbursement from government and commercial insurers, but that is no longer the case.
Patient collection rates now have a significant effect on medical providers’ financial positions, making it critical for healthcare organizations to adopt a modern approach to billing and broaden their understanding of their patients and how they’re paying their bills. In order to understand this, providers must first understand what creates friction in the bill pay process.
Friction — an aspect of patient financial interactions negatively affecting patient experience — can occur at any point in the payment process, complicating a provider’s ability to collect. In the past, the most common source of friction was patient confusion about how much he or she owes for services after insurance. Today, with large percentages of Americans being inadequately insured, an increasing number of patients are stressed about making ends meet. This financial uncertainty means it is more important than ever for patients to understand the upfront payments required at the time of care. Because of this, it is also essential for healthcare organizations to provide digital tools that allow patients to keep them involved in the revenue cycle over time. Digitizing patient collection strategies using automated tools is crucial to facilitate faster payments and a higher collection rate.
One way to do this is to assess patients’ propensity to pay. What patients owe and what they can afford may differ, especially when they are just returning to work and may have other bills to catch up on. Zotec’s Propensity to Pay™ tool can forecast a patient’s ability to pay, and it is proven more valuable than price estimators in helping healthcare organizations develop more effective collection strategies. These tools help organizations fine-tune the financial counseling aspect of making payments by determining a patient’s likelihood of paying out-of-pocket expenses based on credit history and past payment behaviors, among other factors. With this knowledge patient services employees are empowered to connect patients with appropriate payment options or financial assistance in advance of services.
In fact, some consumer-centric providers are already leveraging propensity to pay tools in order to personalize the patient financial experience, according to the Healthcare Finance Management Association (HFMA). As seen in its Consumerism Maturity Model, providers who have mature post-service communications use artificial intelligence and other technologies to calculate a patient’s likelihood of paying a medical bill and leverage the information to tailor financial communications.
Providing customized experiences allows providers to connect with patients on their level, which helps providers implement the payment and billing processes their patients want. This can enhance the overall experience to retain and attract patients, while adding another layer of communication and empathy to the Patient Bill Care™ experience. To learn more, schedule a consultation with one of our experts.