Introduction 

Increasing patient financial responsibility is putting pressure on patients and medical providers alike as patients grapple with higher copays, deductibles, and out-of-pocket expenses while providers re-evaluate how they collect payments from healthcare’s new largest payer. RCM leaders have invested heavily in process improvements and technology around payments from payers, making less effort to focus on patient payments. Historically, providers could count on commercial payers to manage their revenue, followed by Medicare and Medicaid payments, and then patient payments. Patient responsibility has grown nearly 30% since 2015, creating new challenges for medical providers as bad debt and aging A/R  can do more damage to a practice’s financial health than in previous years when patient payments represented a much smaller percentage of provider revenue. 

In the 2019 RCM Trends Survey, Relatient, the industry leader in patient-centered engagement, asked over 100 healthcare leaders across 13 specialties to share how this growing trend is affecting them, where they face the greatest revenue cycle management challenges, and how they are currently managing crucial revenue processes, including collecting payer information, copays and deductibles, educating patients about their financial responsibility, and collecting balances after insurance. The survey data also offers insight to how healthcare leaders are adopting and using HealthIT to address the rise in patient responsibility and where there are gaps. From the survey data emerge six significant patient payments trends affecting medical practices and their patients; the following pages explore each trend and offer a few ways to improve the financial experience for patients and providers. 

    6 Patient Payment Trends Affecting Medical Offices and Patients

    1. Utilizing traditional RCM processes in a new payer environment 

    The 2019 RCM Trends Survey asked healthcare leaders how they are currently managing major RCM processes, like registration, collecting payer information, and collecting copays, deductibles, and balances after insurance. Survey respondents reported manual phone calls, paper statements, and email as the primary methods for carrying out these crucial tasks on a daily basis. 

    Unfortunately, in today’s healthcare landscape, these traditional practices simply can’t produce the outcomes providers need. The patient financial responsibility is too large to rely on these practices to collect patient payments as they are time-intensive for staff and these communication methods are often ignored or simply lost on today’s patient who is looking for convenient communication and payment options. 

    2. Relying on the patient portal as the primary tool for mobile communication and engagement 

    87% of healthcare leaders surveyed reported the patient portal as their mobile technology strategy for improving patient engagement. This is problematic for medical practices because portal adoption is difficult to achieve, though existing patients may register for the patient portal, regular use of the portal remains very low and fail to engage first-time patients to the practice. 

    Portals are important tools for empowering patients with access to their own clinical data, medical history, and current care plan. It’s an excellent way for patients to be more engaged in their own health and share information with other providers. But when it comes to the daily communication surrounding appointments, lab results, follow-up and preventive care, intake, patient satisfaction, and collections, the patient portal isn’t capable of producing the desired results because it’s locked behind apps, usernames, and passwords. Patients simply don’t have the interest or patience for this level of restricted access and therefore won’t engage regularly through a portal. 

    Mobile-first patient engagement strategies yield better results because they utilize the technology patients prefer and already use to carry out their daily routines. This kind of patient-centered engagement, when integrated to the EHR or practice management system, also offers clinic staff superior efficiency because data is easy to access. The right patient-centered engagement partner can also help drive portal adoption, helping medical practices achieve better utilization of the technology they invested in so heavily.

    3. Missing the opportunity to pre-register patients

    When asked how patients complete pre-registration, over 40% of healthcare leaders surveyed said they use their patient portal, followed next by over 20% who reported having no pre-registration process, and next with over 15% reporting manual phone calls as their pre-registration method. The low adoption rate of patient portals and the manual burden on staff required to make phone calls means these strategies are unreliable and can’t deliver the combined RCM benefits of beginning the patient financial experience early and the efficiency offered through automation.

    Pre-registration is a prime opportunity for practices to set patients up for a transparent, convenient, and timely billing and payment process. Pre-registration helps provide office staff payer information early in the patient journey so they can verify coverage and begin the education process with patients. The earlier the financial conversation takes place in the patient’s journey, the better the patient can plan, ask for assistance, or create a payment plan with the clinic. It also reduces patient anxiety, A/R days, and wait times and produces a better overall patient experience.

    The key to a successful pre-registration process is a multimodal strategy, anchored in mobile-first technology,  so patients can complete the proper forms according to their schedules and on the device of their choosing, without requiring the use of an account or password. 

    4. Overlooking the role of text communication in patient collections 

    When it comes to accessibility, text messaging is king—having a 98% open rate and an average 90-second response rate. Yet, when asked about the mobile technology used to engage patients, only 5% of survey respondents reported using text to communicate patient balances. Most depend on mail, email, and phone calls to track down patient payments, methods that are expensive in both material costs and staff resources. 

    What’s more is that because it’s known that patients are far more likely to respond to a text message, connecting patient balance messaging to strategic bill-pay hyperlinks or a text-to-pay solution will not only speed the rate at which a practice can collect patient payments, it can also help them collect more revenue. It’s common for physician practices to write-off patient balances that fall under a certain threshold as it’s too time intensive and expensive to chase down small balances from patients. Mobile-first strategies, anchored in text messaging, not only simplify the process of notifying a patient of a balance due, removing the barrier to billing small balances, but it also simplifies the process of making the payment for the patient. 

    5. Outsourcing collections to a third-party billing company 

    Nearly half of all respondents surveyed said they outsource patient billing to a third-party billing company, a trend that’s expected to grow as patient collections continue to play an important role in provider revenue. Third-party billing companies can often provide healthcare leaders expertise and cost savings through vetted processes, technology, and other resources. Outsourcing patient billing and collections also frees clinic staff to engage with patients in the office and carry out other tasks.* 

    *Relatient is not a third-party billing or RCM company.  

    6. Operating within a 45+-day A/R cycle 

    43% of healthcare leaders surveyed reported that patient balances are reported as overdue after 45 days or longer and 51% reported that a patient balance is considered bad debt and turned over to collections after 120 days or longer. While these time frames have previously served as standard A/R cycles, the shift in the consumer experience and the role patients now play as significant payers means these timeframes can and should change.  When practices use an extended A/R cycle, they are essentially funding the care they provide to patients. In no other industry do patients expect to receive goods or services and wait several months to pay for those goods and services. Yet, healthcare still struggles to educate patients about their financial responsibilities on the front-end of the patient journey and hesitates to collect early. New RCM processes, like pre-registration, patient balance messaging, collecting copays and deductibles at the time of service or even prior to the appointment, and mobile payments are designed to help patients know what they should expect to pay and pay their balances sooner. This means practices can begin to tighten their RCM timelines and collect more revenue, further strengthening the financial health of the practice and ensuring patients will have access to their provider of choice for the long-term.

    Conclusion

    Creating patient-centered RCM processes offers patients the financial experience they want from their healthcare providers and offers medical practices improved outcomes like increased revenue, reduced aging A/R, fewer write-offs and bad patient debt, and added efficiency for clinic staff. Mobile-first strategies can help practices optimize the patient journey, including tasks that set the stage for a smooth billing and financial experience, balance messaging to engage patients in a financial conversation via text, and mobile payments that speed revenue collection, can auto-post payments, and save staff countless hours of time spent calling patients and mailing statements.

    At Relatient, patient billing is a component of a larger patient engagement strategy that streamlines the patient journey, expands patient access, and improves patient-to-provider communication. Relatient’s platform is built for scalability and intuitive patient adoption. Because our solutions are never housed behind accounts, apps, usernames, or passwords, patients engage the same way they do their other daily obligations. Security and best practices are built-in to every solution so medical office staff can be assured they are compliant with regulations like HIPAA, CAN-SPAM, and TCPA. To fuel efficiency, the platform integrates with over 85 EHR and practice management systems so data is easy to access and act upon. 

    If you’re looking for a patient-engagement partner who can help you consolidate vendors and optimize the patient journey, Relatient can help. Contact one of our healthcare specialists to schedule a time to learn more. 

    If you’d like a copy of the 2019 RCM Trends Report, contact us and we’ll send you a copy.

    Make text, email and voice an integral part of your patient engagement.

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    Source: Delivering a Patient-Centered Financial Experience