How to Leverage Patient Engagement to Help Improve Patient Collections

Patient financial responsibility for healthcare costs accounted for 5% of provider revenue in 2000. Today, that number is 35%, making patients the third largest payer just behind Medicare and Medicaid.¹ To be sure, the increase in patient responsibility is challenging for providers as they attempt to collect. But it is also a challenge for patients, especially those on high-deductible health plans or for those without coverage. A recent survey found 64% of patients have delayed or skipped care because of costs.² When this happens, quality outcomes diminish right along with payer reimbursement. But there are things providers can do to mitigate the potential damage to revenue while helping patients get the care they need. 

Develop a Price Transparency Plan Now

Unlike traditional payers who have access to the cost of services and member plan detail, patients most often do not. Just as they budget for groceries and utilities, patients need information to help them budget and pay for healthcare costs. But without knowing those costs, doing so can be difficult.

According to a report published by PWC, 60% of patients say they’ve never had a financial conversation with their provider about the price of a procedure.³ A recent provider poll by Change Healthcare supports that statistic. When asked at which stage they were in offering a price transparency tool to patients, 37% of respondents said they hadn’t started and 34% said they were still researching options. Only 29% said they were already offering a tool—somewhat low considering new and impending legislation aimed at improving price transparency and lowering healthcare costs.⁴

There are simple things all providers can do now to increase transparency and prepare for new mandates.

• Educate staff and management about upcoming legislation to show urgency and gain buy-in for process improvements.
• Leverage tools that generate patient responsibility estimates prior to or at the time of service and ensure staff can understand and communicate the information to patient.
• Recommend self-service tools to patients to help them better understand healthcare costs. Resources such as Nerd Wallet, healthcare.gov, or healthmarkets.com are good options.
• Teach front-office staff how to have a positive financial interaction with patients. This should include soft skills such as active listening and compassion. 

Create a patient-centric collections strategy

Having a plan to improve price transparency is just the beginning. To truly improve patient collections, you need to develop a collections process that focuses on each patient’s unique financial situation and preferences—one that mimics a retail experience. And that process should begin no later than the time of service. According to a recent poll by Change Healthcare, 58% of providers still collect the majority of patient responsibility after service is delivered. This approach was fine when patients owed nothing more than a small co-pay. Unless providers adopt a more patient-centric strategy, they risk damaging both their bottom line and patient satisfaction. 

An effective patient collections strategy should include the following:

• Collect or arrange for payment no later than time of service.
• Offer multiple ways to pay such as automated phone systems, online payment portals, digital payment tools, and FSA/HSA cards.
• Use communication tools for payment notifications customized to each patient’s preferences.
• Leverage propensity-to-pay analytics to inform the financial conversation and identify options such as financial assistance or charity care.
• Provide flexible payment plans. 
• Create statements that are clear, concise, and easy to understand.
• Ensure all departments are following the same collections practices to create a consistent patient financial experience.

Measure and monitor

Every healthcare organization is different and there is no one-size-fit-all model for patient collections. Providers need to continually review what’s working and what could work better. The place to begin is to determine which areas are most concerning for your organization. A poll by Change Healthcare asked providers which areas of collections did they find most challenging. Fifty-two percent said getting paid faster was most challenging; 24% said integrated patient communications; and 16% said driving patient satisfaction. 

Following are four guideposts that will help you identify areas in most need of attention. They can also help you as you monitor progress toward your goals.

• Self-pay collections broken down by pre-service, time of service, and post-service. By focusing on improving the first two, post-service collections should decline dramatically.
• Patient satisfaction, both clinical and financial, broken down by issues or reasons. For example, you should be tracking the reason for calls into your office. This can indicate specific areas needing improvement, such as statements that are difficult to understand.
• Cost-to-collect across staff (including efficiencies). Providers can lose as much as 20% of every dollar by selling receivables too early. By developing more patient-centric collections processes, providers can collect more earlier and reduce the need for multiple statements or outsourcing to an agency.
• Bad-debt metrics. Watching your bad-debt trends can help you identify problematic areas, especially regarding internal processes. It may as simple as training staff on how to ask patients for payment more effectively. 

Choosing the best technology partner for your organization

Providers are continually being asked to do more with less. Whether you’re a large hospital or a small provider practice, it can be challenging to find the resources to pull together and implement an effective patient collections strategy. Partnering with industry experts is a great way to help streamline the process and achieve your goals faster. But it’s important to choose a vendor steeped in the healthcare industry. There are many healthcare startups run by smart people trying to get into our growing industry. They may have a good product but do they have the vast experience required to truly understand the challenges providers face, including regulatory requirements, complex revenue cycle processes, or value-based care mandates? 

Partnerships are about more than a product or service. They’re about continual innovation and working side-by-side with providers as the industry changes to meet new challenges as they arise. Following are a few guidelines for choosing a partner. The best vendors should be able to: 

• Offer technology that integrates seamlessly with a provider’s existing systems and workflows, 
• Work with providers to strategize, launch, and maintain all facets of the patient financial journey,
• Provide a comprehensive suite of solutions to manage the entire collections process from eligibility confirmation to patient estimates to payment options, and
• Deliver in-depth analytics to provide actionable insight for continuous improvement.

The bottom line

A great clinical experience can be completely offset by a negative financial experience. Why does this matter? Because, according to a recent hospital study, patients who are satisfied with the billing process are more likely to recommend the provider (82%), more likely to pay their bills in full (95%), and more likely to return to the same provider for care in the future (74%).⁸ Partnering with industry experts can help providers improve price transparency, elevate the patient financial experience, and achieve their collections goals faster and more effectively. 

1 Michael Evans, "What We Can All Do About Rising Healthcare Costs," Forbes, June 28, 2017
2 Sara Heath, "64% of Patients Avoid Care Due to High Patient Healthcare Costs," Patient Engagement HIT, February 15, 2018
3 "Top Health Industry Issues of 2016," PWC, December 2015
4 "Trump Administration Announces Historic Price Transparency Requirements to Increase Competition and Lower Healthcare Costs for All Americans," [Press Release], HHS.gov, November 15, 2019
5 Terry Reinsager, "Why You Should Offer Patient Payment Estimates in Advance of Care," MediRevv, April 13, 2017
6 Academy of Healthcare Revenue
7 Brooke Murphy, "5 patient payment trends affecting payers, providers in 2016," Becker's Hospital Review, June 22, 2016
8 Kelly Gooch, "Study: Satisfied patients more likely to pay medical bills in full," Becker's Hospital Review, March 16, 2016