June 4, 2019

Using data insights to provide cost-of-care estimations and payment terms that best meet your patient’s needs

High deductible health plans and increased payment responsibilities are changing how patients choose where to go for their healthcare. Patients are demanding a more consumer-focused experience that allows for transparency in pricing, payment options, convenience, and simplicity in paying their bills.

Understandably, patients want to know how much they’re going to pay for a treatment or a visit before they receive a bill, as well as what kind of payment options are available. Despite this widespread desire, healthcare organizations are still struggling to help consumers understand what their healthcare costs are going to be and are leaving it up to the patient to pay the full amount.

As a result, a large disconnect exists between what the patient wants in their financial experience and what some healthcare organizations are currently providing. According to a 2018 consumer healthcare report, Americans “have been conditioned to believe that when it comes to questions about healthcare costs, the answer is not in their reach. “It depends on your insurance plan,” “the doctor needs to file the paperwork first,” and simply “I don’t know,” are all standard answers when consumers inquire about prices.”

The report found that 70% of patients asked pricing questions, only 23% received an answer, and more shockingly, nearly half said they felt “stupid” for asking.

Most hospitals have the ability to provide an estimation of cost (for example, EPIC has a module in their EHR that does this automatically) but are hesitant to make this part of the patient pre-engagement process. Why? Healthcare leaders have noted that estimates provided before an episode of care are not always accurate and can be misleading, can lead patients to go elsewhere, or the price tag may scare patients OUT of receiving ANY care.

Some healthcare leaders put the onus on insurers to provide pricing expectations to patients – since insurers, in their opinion, are better equipped to tell patients what they’ll owe for particular services, claiming there’s no infrastructure in place giving providers access to the necessary information. But, that argument is losing ground as more hospitals partner with vendors to offer a more consumer-focused financial experience that uses out-of-pocket cost estimates, data analytics, customized patient communications, and financial arrangements.

Taking a more consumer-centric approach is proving to be successful. When healthcare costs are clear and up-front and the financial journey is streamlined for patients, a hospital’s collection process and uncompensated care are improved.

Adopting a Consumer Mentality for Healthcare

In every other industry outside of healthcare, Americans have the freedom to shop around and understand what services will cost. For example, when a consumer is looking for a new car, home improvements, auto insurance, or elective procedures like braces, a consumer will call around for multiple estimates. If they cannot easily afford it, they may:

  1. Go with the cheapest option to get them through the crisis
  2. Save money and address the issue later than planned
  3. Do the work themselves
  4. Choose not to do anything

So, how does a hospital help a patient prepare for their financial obligation in this light while also balancing their healthcare needs and outcomes?

Step 1: Change the pre-service conversation with your patients. Help your patients early in the game to prepare them for their financial obligations. Begin using estimation tools even if the estimations are not 100% accurate. Providing patients with an idea of how much a service or treatment is going to cost will help ease the feelings of fear and unknowns of what to expect financially.

Step 2: Understand their financial situation early in the game. Analytic services like predictive scoring and patient screening will help you understand your patient’s ability to pay and get them on the right payment path. Available options include payment in full, partial payments, payment plans, patient financing, or even encouraging those who qualify to apply for financial assistance or state programs (Medicare and Medicaid) during these early stages.

Step 3: Communicate. By understanding your patients and their financial situations, you can incorporate your patient insight/data into to your communication program. Your statements can be personalized to fit their needs and situations, and you can use the right methodology in communicating with them – whether it be through statements, email, text, phone, or a combination of all or some. The goal is to empower your patients with the knowledge, the flexibility, the understanding, and a helping hand so that they can successfully pay their healthcare bills.


RevSpring Can Help

RevSpring’s eVoke™ engagement platform leverages patient data and predictive analysis to automatically match financial conversations and payment options to each patient. With eVoke, the patient financial experience is intuitive across all touchpoints. When the right financial path is clear, it leads to greater patient satisfaction and the best financial outcomes. It is the only analytic technology platform that delivers actionable intelligence coupled with omni-channel communication and payment execution in an end-to-end RCM patient engagement solution.