Achieving a positive patient experience
Discover three best practices for an enhanced patient financial experience.
A patient financial services director recently shared a quote with me from a patient describing her hospital stay: “The staff provided great care, but I feel like I just had a house drop on me, because I got my hospital bill and cannot afford to pay my balance.”
This isn’t an uncommon situation, as rising insurance deductibles are increasingly becoming a source of financial anxiety for patients.
In 2017, the Kaiser Family Foundation found that multi-person families enrolled in private health insurance plans don’t have enough liquid assets to cover their cost-sharing obligations.
Research showed only 47% of households could pay $4,000 of their liquid assets towards cost sharing, and only 35% could pay $12,000.
Patients have their health to worry about, and medical bills only add to their stress levels. That’s why best-in-class organizations are optimizing and automating front-end processes to achieve three best practices for a positive patient financial experience.
Step 1: Provide patients with estimates before providing care
Advisory Board research and our Optum® Advisory Services consulting experience with health care providers across the nation confirms what patients want most is rather simple: to avoid the dreaded surprise medical bill.
A key to helping prevent this event from happening is encouraging medical groups and health systems to consistently and proactively provide patients with out-of-pocket costs prior to rendering care.
Leveraging technology capabilities to automate key steps in the financial clearance process, such as eligibility verification, obtaining prior authorization and generating patient out-of-pocket estimates, are critical pieces to providing much needed estimates.
It is also important to understand patient threshold preferences for patient responsibility (e.g. if patient responsibility is less than $100), and how they would like to receive their estimates.
Most organizations today rely heavily on reaching patients via phone to provide estimates pre-service, yet revenue cycle leaders nationwide agree this tactic is burdensome on staff and ineffective in reaching patients. Why the decline?
More and more patients prefer to interact with their health care providers virtually through email, text or on-demand self-service options.
Understanding patient preferences and thresholds around when and how they expect to receive their out-of-pocket responsibility is crucial to fostering patient engagement in their financial experience early in care to prevent obligational stresses later.
Early involvement also benefits your organization because providing an accurate estimate to a patient prior to care greatly increases the likelihood of patient payment.
Furthermore, Advisory Board research shows that asking patients to pre-pay something — often as little as $20 — is effective in maximizing point-of-service collections and preventing future bad debt.
Step 2: Make it easy for patients to pay
In this price-transparent world, organizations should give patients a full view of their financial obligations (upcoming, current and outstanding balances) while offering multiple payment channels.
Consistently providing a positive collection process is not easy — even those providers who have consolidated medical groups, hospital billing and patient collections departments must contend with patient confusion from other bills received from anesthesiologists, etc.
To increase the likelihood of patient payment and to provide a positive experience, organizations must take steps to help make the payment process a hassle-free experience.
Consider the following questions:
- Is your online bill pay easy to use? Does a patient need to have his paper bill to be able to make an online payment?
- What percentage of your patients are making payments via phone? Online? Mobile? How does that percentage match up with how your patients would like to pay?
- Has your organization consolidated patient statements (paper and virtual) and customer service teams supporting self-pay and balance-after-insurance payments to help provide a one-stop shop for your patients?
If the answer to any of these questions is "no" or “I don’t know,” it may be time to revisit your collections practices from a people, process and technology perspective.
Do your people have access to the right information and responsibilities for taking care of patient obligations across your health care system?
Do your processes support providing patients with a convenient payment experience, pre- and post-care? Is your technology easy to use? Do you have gaps in key capabilities across online, virtual or self-service functionality?
At Optum, we believe “the last impression is the lasting impression,” and because the payment process is often the last interaction patients have on their care journey, it is important that the impression is a positive one.
Step 3: Arm your staff to support your patients' financial well-being
Given patients’ increasing anxiety around medical bills, organizations across the country must properly invest in both adequate staffing and skill development to enable patient-facing staff across scheduling, pre-services, registration and financial counseling/advocacy to have respectful, honest conversations with patients about their financial responsibility.
Generally speaking, patients understand copayments — they have been paying them to see their primary care physician for decades. But coinsurances? Deductibles? What if a patient has a copay too?
Patients are confused by the increased complexity, and ensuring your staff understand how to navigate patient out-of-pocket conversations and serve as an expert resource is key to improving their financial experience.
Ensure your staff: 1) understand the different types of patient obligations; 2) can explain these types of obligations to patients who are not familiar with the terminology; and 3) can easily access patient-specific information about out-of-pocket responsibility to have tailored conversations.
Keep in mind these best-practices for communicating with patients:
- Insurance in 2018 is confusing — be prepared to help educate patients on what they owe and why they owe it.
- Help avoid a surprise bill by being transparent with patients about their potential out-of-pocket responsibilities before care is provided.
- If you are unable to provide an accurate estimate to a patient for any reason, briefly explain why you cannot do so, offer options to consider (e.g. Has the patient tried to call his insurance company? Does he know his out-of-pocket maximum amount?), and offer to connect him to staff within the organization who may be able to provide assistance (e.g. financial advocates).
- Let patients know one of your goals is to help reduce financial guesswork and make the payment process as easy as possible. If a patient anticipates difficulty making a payment, be sure to mention flexible payment options your organization may offer, such as payment plans and/or discounts for prompt payment.
You don't have to navigate this road alone
Delivering an enhanced patient financial experience is a challenge whether your organization is large or small.
At Optum, we are committed to partnering with organizations to enhance the financial experience for patient communities across the country. Seeking help in your efforts? Need help getting traction on an idea? We’d love to hear from you.
