Electronic Health Reporter

By Srulik Dvorsky, CEO and co-founder, TailorMed.

The rising out-of-pocket costs from health insurance is one of the most common barriers to health care for patients. According to a recent study, 46 million people cannot afford needed care. With significant increases in job loss due to COVID-19, many people have become uninsured and are deferring care, which consequently places financial burdens on healthcare systems.

Further, many patients who are uninsured or underinsured don’t know there are financial resources available that could help lower their out-of-pocket costs. Providers are in the unique position to adopt strategies to help remove barriers to treatment using technology, particularly for those struggling to afford care. These can lead to better financial outcomes for both the patient and provider.

Here are four ways technology is helping providers remove financial barriers to care:

Predictive analytics. Healthcare organizations can leverage predictive analytics to proactively identify patients at risk of not affording treatment – and mitigate the financial and personal stress that comes with receiving a costly medical bill post treatment. Providers can analyze patient data including income, propensity to pay, health insurance out-of-pocket cost, and treatment plan to assess financial risk. It can also help prioritize which patients have the highest probability of not affording high-cost care. This level of visibility can help providers identify more patients upstream needing financial care and take the next steps toward reducing the financial burden.

Leverage financial resources. Traditionally the process of finding financial resources has been time-consuming, with healthcare professionals searching across multiple websites and making phone calls to track down funding opportunities. As a result, many funding opportunities are identified after the application window has closed, making it challenging for patients to get the financial support they need. Technology changes the game. Providers can now rapidly match a patient’s specific needs against thousands of available financial resources including: co-pay assistance, replacement drug programs, government subsidies, community and state resources, assistance from disease-specific foundations, and programs that support patients with their living expenses. Real-time alerts can instantly notify staff when matching financial resources become available. The immeasurable boost in time and efficiency goes a long way in helping the patient afford care.

Increasing provider efficiency andrevenue opportunities. Healthcare organizations can uncover revenue opportunities by leveraging automated workflows that help  identify financially at-risk patients, and matching and enrolling them in funding opportunities instead of using a manual approach.  This helps staff to  spend more time treating patients and less time on administrative tasks.

Digital patient engagement tools. As patients continue to demand price transparency so they can understand what they’re expected to pay out-of-pocket, the next evolution in health care consumerism lies with digital tools where the patient can proactively navigate financial challenges throughout their own health journey. With providers offering these self-service tools, patients can advocate for themselves, make informed decisions and help reduce their own financial barriers to care. This will provide an empowering patient experience.

The quicker providers are at identifying patients challenged with affording care and enrolling them in matching financial resources, the more successful they can guide them on their journey to better health.   As a result, health systems can effectively treat more patients, and improve financial outcomes for their own organization as well. Technology can help providers achieve this goal.