It’s 2016, and the days of insurance dollars dominating the payor mix have officially ended. America’s Health Insurance Plans (AHIP) expects out-of-pocket payments for insured patients to increase 68% in five years. In some hospitals, the rate of bad debt for insured patients is increasing by over 30% per year. So yes, our actions as healthcare providers will need to change.
When I started my job in revenue cycle consulting, we focused on insurance billing and collections. While we all know collecting from insurance companies isn’t a walk in the park, it is significantly more orderly and predictable than patient collections, which was mostly just gravy on top of your bottom line. However, over the past couple years, the growth in size and amount of high deductible health plans (HDHPs) has taken patient responsibility from hard to ignore to absolutely essential.
Healthcare providers have spent many years focusing on building competencies around payer payments, but now they must develop effective patient collection strategies in order to maintain their profit margin.
Now that a lot of Americans are responsible for a majority of their medical expenses, providers must understand the issues and strategies for managing this debt. The change towards HDHPs means that our billing and collection strategies directly influence patient satisfaction, timely payments and ultimately the ability to provide quality care.
So how can we make a difference? It’s not too complex and much of it has already been proven in other industries. We need to:
Bring clarity into the situation: Make sure the patient has an understanding of their insurance coverage before and throughout the process.
Provide payment options: Give your patients flexibility when it comes to paying their bill. Every patient and insurance plan is different. Don’t pretend like they are all the same.
Engage your patients with humanistic communication: Maximize the likelihood of reaching and engaging your patients by personalizing your communication to make it truly resonate. For example, a 25 year old will respond more favorably to a text or email than the traditional phone or letter.
I’ve spent the past 7 years addressing these concerns. I’m in the business of helping others find a solution that best fits their situation and their companies needs. If you are a healthcare provider who is being affected by patient billing and collections or other revenue cycle related issues, please reach out and lets find a solution for you.