Five Strategies for Better Patient Access and Financial Engagement

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With the rise of healthcare consumerism, people are looking to hospitals, health systems, and physician practices to deliver the same user-friendly, digital experiences they receive from other industries. More specifically, people want to easily make appointments, understand what their financial outlays will be, make payments, and set up payment plans if the estimated costs exceed their budgets—all via their mobile devices or tablets. Unfortunately, most healthcare organizations aren’t ready to provide this level of convenience. In part, this is because they have relied on patient portals as their main digital engagement tools to date.

The problem with portals

There are a few reasons why patient portals underdeliver. First, they don’t mirror the experience consumers have come to expect from digital solutions. The interfaces are clunky, the functionality is limited, and the technology supports a pull strategy, meaning that it waits for the patient to come to it rather than periodically reaching out and prompting the individual to take action. Second, a patient must be logged into a portal before they can do anything with it. And to log into a portal, the individual must already have a relationship with the provider. This makes it harder to schedule appointments with new physicians because there is not an established connection. In these cases, the patient must pick up the phone, wait on hold, set up an account, possibly wade through insurance approval and pre-authorization, and then make the appointment. This is a significant deterrent for proactive care management. Third, portals aren’t ideal for communicating about costs. While some allow the patient to pay co-pays, they aren’t designed to give realistic cost estimates, offer payment plans, suggest alternative funding sources, and so on.

Taken together, these challenges result in low portal use. Even if a hospital indicates that 50% of its patients access the portal, those individuals may only be using it once, getting frustrated, and avoiding it in the future. One-time or limited use should not be viewed as patient engagement. Instead, to realize true engagement, organizations should be thinking about ways to foster two-way conversations that keep patients focused on their health and how the hospital, health system, or physician practice can meet their needs.

What are the risks of poor digital engagement?

Without a well-considered plan for capturing patient attention and smoothing access to care, healthcare organizations run the risk of losing customers. As retail clinics pop up around the country, and the healthcare marketplace becomes more competitive, organizations must find ways to break down the barriers to care and give patients ways to make appointments and pay for services without jumping through hoops. This is especially important as the population ages and millennials become the number one healthcare consumer in the nation. This generation is currently helping their parents navigate care while managing their own health and tending to their children’s needs. And this group has grown up completely digital, hardly remembering a time when they didn’t use their phones to manage their lives. By not providing digital tools to this and other generations that are becoming more tech-savvy, healthcare providers are going to miss key opportunities to attract and retain patients in both the short and long term.

Regulatory pressures are also making patient-centric financial communications a necessity. Several states are implementing price transparency regulations, and a federal requirement is right around the corner. To meet these standards, organizations will need effective tools that reliably determine and share prices with patients in advance of their appointments.

So where do organizations go from here?

It’s clear that patient portals are not the answer to consumer-friendly patient access and financial engagement. But how can organizations do a better job of giving patients the convenience they seek? Here are five best practices to consider.

  1. Reevaluate your organization’s existing tools. The first step is to take a hard look at the digital solutions you currently provide and compare them to those available from other industries, such as travel, retail, and financial services. Don’t be fooled into thinking that only younger people want these tools. Research shows that more and more older adults are embracing mobile activities like online banking. It stands to reason that these same users would be interested in solutions that ease the healthcare scheduling and payment processes.
  2. Adopt tools that help people understand their care costs. The more patients understand what they owe and feel confident that the cost information provided has taken into consideration their current insurance, deductibles, and co-pays, the more likely the patient is to pay their portion of the bill upfront. A key to accurate estimates is the right financial clearance solution that checks the patient’s insurance digitally, determines the benefits, reviews the amount of any deductible and verifies whether the individual has already met their deductible. When a patient financial tool also offers the ability to make payments or set up a payment plan, it can increase patients’ propensity to pay, boost the amount of self-pay funds the organization collects, and substantially reduce the cost-to-collect.
  3. Streamline access to shoppable services. These are elective procedures and screening tests that an individual can schedule in advance and include things like planned joint replacements, colonoscopies, and mammograms. Healthcare organizations offer standardized pricing for these services, allowing patients to shop around for the best price and experience. When patients are able to use a digital tool to research a service, set an appointment, and make a payment, it can drive patient satisfaction and increase the chances the individual will choose to have the procedure with the organization supplying the tool.
  4. Enable digital appointment scheduling. Mobile tools and apps that patients can use to schedule appointments, monitor wait times, digitally complete forms, and check in for appointments are essential to breaking down some of the barriers to patient access. Before onboarding a tool like this, organizations must think through the change management challenges in getting all stakeholders on board. Historically, physicians have been hesitant to open up their calendars to permit digital scheduling. However, transparency and standardization are becoming increasingly important to meet patient demand and are necessary to make these types of tools work.
  5. Retain options for people who don’t want to go digital. Although digital tools are gaining popularity among all generations, there are still people who prefer to pick up the phone and schedule, price, and pay for care. Organizations should have service-oriented call centers to work with these patients. Such centers should have well-trained professionals who are available during and outside of traditional business hours, so patients can access the information they need when they need it.

Relying on the status quo is not wise

Healthcare is only going to become more consumer-driven as high-deductible health plans continue to disrupt the industry. Hospitals, health systems, and physician practices cannot afford to rely on outdated technologies that don’t facilitate two-way conversations or the digital experience patients expect. Organizations should be seeking partners that offer the latest technologies that put the patient at the center and enable transparent and informative communications that improve an organization’s clinical and financial outcomes.

Bill Krause is vice president and general manager of Experience Solutions for Change Healthcare