Rising patient financial responsibility is taking a toll on the bottom line of hospitals and health systems across the country. In a recent review, private/self-pay accounted for 68.4% of hospital revenue on average, while Medicare’s percentage of net revenue was 19.8% and Medicaid’s was 13.1% 1. A troubling outcome of this updated payer mix is that self-pay after insurance accounts for almost 58% of bad debt 2.

But the financial pressure isn’t just affecting providers. Patients are struggling too. Before they even walk through the door for care their costs have skyrocketed. For example, the average premium for employer-sponsored family coverage increased 43% over the last ten years, while the average deductible for single coverage increased 61% 3.

After care, an estimated 100 million Americans have amassed nearly $200 billion in collective medical debt 4. For patients, medical debt has become a leading cause of personal bankruptcy, with an estimated $88 billion of that debt in collections nationwide, according to the Consumer Financial Protection Bureau.

Engaging patients earlier in the process and with their preferences in mind is important. Providing a better patient financial experience makes it easier for patients to understand and pay their bills thereby improving collections.

Activate Technology Early in the Process

Use technology early in the process to educate patients about their financial responsibility and better identify and alleviate risk:

  • Patient responsibility estimation. Inform patients of their remaining deductibles and costs and provide an estimate of their financial responsibility prior to service. When patients understand what they owe – and why – they can better plan and make more fully informed decisions about their healthcare. For providers, this offers an opportunity to improve upfront revenue capture and reduce collection costs.
  • Propensity to pay analytics. Identify each patient’s unique financial situation using intelligent scoring and demographics. This helps identify which patients may be eligible for financial assistance. Patients appreciate that their provider is willing to help them access financial aid in obtaining the care they need. Plus, providers are less likely to have to write off balances unnecessarily.

Customize Payment Plans

Every patient’s financial journey is unique. Patients may face challenges such as unexpected debts, shifting family situations, and changes in employment status, which may impact their payment ability. Having a uniform collections process for all patients may not produce optimal results. Ideally, a better approach is to tailor payment plans according to each patient’s distinct financial situation. These personalized plans must be adaptable enough to include additional balances over time while keeping payments affordable. Adopting such patient-centric plans enhances the overall patient financial experience while also increasing the likelihood of providers receiving payment.

Offer Multiple Payment Options

Just as each patient’s financial situation is different, how they prefer to pay varies as well. By catering to these preferences and offering a variety of payment methods, patients are likely to settle their bills more quickly. Methods include digital payments on mobile devices, online payment portals, and voice portals, as well as payments by mail or in person.

Deliver an Individualized and Compassionate Approach

Every interaction matters—to both your bottom line and your hospital’s reputation.

Consider outsourcing with a partner who acts as an extension of your organization’s team and is committed to service. They should understand and embrace your hospital’s culture. When evaluating partners, ask how they hire and train their teams. Do they regularly monitor calls to ensure quality and best practices are being met, holding representatives accountable for delivering quality? Finally, do they conduct patient satisfaction surveys?

Partnering to Provide a Superior Patient Financial Experience

Self-pay outsourcing partners are crucial in enabling hospitals and healthcare providers to maximize their revenue and enhance the patient financial experience. However, selecting the right partner is critical to achieving an optimal return on investment. The ideal outsourcing partner adopts industry best practices and a patient-centric approach to their services. By doing so, they not only help to improve your financial performance but also contribute to overall patient satisfaction. A reliable outsourcing partner can make a significant impact on your organization’s bottom line and reputation.

1 https://www.definitivehc.com/resources/healthcare-insights/breaking-down-us-hospital-payor-mixes

2 https://www.healthcarefinancenews.com/news/high-out-pocket-costs-are-negatively-affecting-revenue-cycles

3 https://www.kff.org/report-section/ehbs-2022-summary-of-findings/

4 https://abcnews.go.com/Health/wireStory/states-confront-medical-debt-bankrupting-millions-98545059

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