Electronic Health Reporter

By Bird Blitch, CEO and co-founder, Patientco.

Since the rise of the COVID-19 pandemic, many leaders in the healthcare technology space talk about the concept of transforming the patient experience by providing a “digital front door” for their patients. Of course, for those of us who have been working to transform and move healthcare in a consumer-focused direction for a long time, we remember the bold proclamation of a digital “new front door” from Larry Merlo in late 2017 as the CVS Health and Aetna merger promised a radical change in how patients access and receive their care.

This new industry buzzword is built on the initial concept – the “digital” front door. And, even though disruptions in the healthcare industry emerged prior to the pandemic, according to a 2018 Adobe survey, only 7% of healthcare and pharmaceutical companies said they had gone digital, compared to 15% of companies in other industries. Furthermore, despite the fact that the U.S. healthcare market is projected to reach $5.7 trillion by 2026 in national health spending, the industry continues to be a laggard when it comes to investments in digital transformation.

While many hospitals and healthcare facilities were recently forced to ramp up their focus on digital transformation and telehealth efforts, significant gaps still exist, especially when it comes to patient billing.

Shifting the burden

Like a loose screw or hinge in a door, when one area of the revenue cycle is not optimized, the rest of the organization shoulders the burden. For example, health systems without a modern billing strategy report that confusing paper statements filled with medical jargon and the lack of clarity on what insurance covers is a big reason that patients call their health system. As patients experienced delays in receiving bills due to the Postal Service crisis last summer, the need for digital delivery options has never been greater.

To create a transparent and intuitive billing experience, patients need a personalized, digital option where they can access and pay their bills on time and set up affordable payment options, even outside of traditional business hours. Patients should also have access to 24-hour support to help them better understand their charges and what their statements mean. Real-time chat options or text options offer this to patients in an efficient and convenient way. These types of digital-first options help patients feel empowered to navigate their healthcare financial experience which, in turn, helps to build loyalty.

Extending bedside manner from the clinical to financial care side

Healthcare organizations strive to provide compassionate clinical care, which involves good bedside manner that informs and empathizes with patients, no matter what their diagnosis. It’s time to extend that bedside manner and offer compassionate patient financial care. Today’s healthcare consumer deserves a focused effort from their health system to provide a  personalized and compassionate financial experience. Health systems in 2020 must collect patient payments to keep the lights on. However, rather than risk earning a reputation for prioritizing the business and bottom line above all else, consider digital-first billing and payment experiences for patients to be an extension of good bedside manner. Healthcare providers can ensure an overall positive experience throughout the full healthcare journey: from making the initial appointment all the way to providing payment options to cover any out-of-pocket costs.

According to the 2020 Annual State of the Patient Financial Experience Report, the biggest concern for revenue cycle and financial team members when collecting and processing patient payments is too many manual processes (25%) and high patient call volumes (18%). A holistic digital experience can help solve this. When health systems offer a secure online, self-service portal for patients to update their records, access their medical history, pay bills, and even schedule appointments, patients become more engaged in their own experience and invested in their health, instead of being intimidated by too many ‘unknown costs.’

Empowering patients

Understanding what health insurance covers is not straightforward to the average person, which can directly impact decisions made about their health and treatment plans. In fact, according to Policygenius, more than one in four people (27%) avoided care or treatment because they were unsure of what their health insurance covered. And, due to the nuanced and complex nature of healthcare, instead of attempting to figure it out themselves, they simply avoid utilizing healthcare services until they are in dire need of it.

In this case, a complex relationship between providers, physicians and insurers creates a barrier for patients. When the barrier to entry is reduced for patients, healthcare becomes more accessible to those who really need it. This can be done through technology that uses data to tailor how patients are engaged and identifies the best payment option for their unique financial needs. Digital tools can recommend a financial plan that works for the patient and ensure healthcare providers get paid on time. Consolidating the multiple bills that patients may receive from one service also goes a long way to removing barriers. From their last visit, 33% of patients received two to three bills – further adding to their confusion about what they owe out of pocket. When patients have transparency on upfront pricing, simplified billing communication, and access to digital features like chat support, they are empowered to make more informed decisions about their healthcare.

Building patient loyalty

Patient loyalty is influenced by payment options and upfront pricing so it’s crucial that healthcare providers get these two right. Even as the Price Transparency Rule goes into effect on Jan. 1, 2021, patients will still find it difficult to understand what their true out-of-pocket cost is. The rule, which requires hospitals to list chargemaster prices and negotiated rates, will not necessarily make it easy or intuitive for patients to understand what their out-of-pocket costs will be. This public list of hospitals’ standard charges, including private payer-negotiated rates, is also only for 300 “shoppable services.”

And, a patient’s out-of-pocket cost is dependent on many factors, including the patient’s insurance coverage information, remaining annual deductible and out-of-pocket maximum. As such, by no means will it solve all the transparency issues faced in healthcare, but it’s certainly a major step in the right direction.

Providers increasingly realize that affordable payments are table stakes for patient loyalty. Nearly one-third of patients would switch providers, even if it was more inconvenient for them if it meant they could access affordable payment options like getting financial help or access to a payment plan. When it comes to younger patients, 37% are more likely to switch providers. The lifetime value of a patient is $650,000, according to data from the Centers for Medicare & Medicaid Services and census data. To keep patients loyal and realize the full value of each relationship, it’s important that healthcare providers prioritize patients’ expectations and implement more digital-first solutions that they are already familiar with in every other aspect of their daily lives.

Today’s patient engagement

Without digital options, patients have limited choices regarding how they engage with their healthcare provider. Traditional methods of communication, such as snail mail, are time consuming to sort and process for the health system but are often the only option. For example, when a patient applies for charity care, they likely have to mail supporting documents, as most organizations do not have a way to process this correspondence digitally.

With the right technology, the health system can accept correspondence such as checks and legal documents from patients through those traditional channels like mail, and digitize them, thus creating a sortable digital mailroom. By spending less time sorting and processing paper mail, a digital mailroom makes it possible for health systems to spend more time focusing on what matters: the patient.

Combining the digital mailroom with a digital-first billing strategy ensures patients have a safe, secure and consumer-friendly channel to engage with their provider. When patients are encouraged to engage digitally, whether online on their computer or through a mobile device, such as their smartphone, they can feel like they are in control of their own experience. These digital experiences help healthcare providers extend compassion from their clinical care mission into the financial services they provide, which further empowers patients and creates lasting loyalty.