By Joe McMurray, senior vice president of patient experience, Zotec Partners.
A July 2022 report confirmed what most providers have seen coming during this time of rampant inflation: Unexpected healthcare costs can be crippling for the majority of Americans. Many factors have influenced this fact, including rising high-deductible plans, ongoing pandemic stress, and the general truth that patients are often sick, scared, or confused — or a mix of all three. This strain poses many challenges for healthcare providers and their revenue cycle teams, highlighting the importance of patient-centric financial experiences.
Calculating cost estimates on unexpected medical encounters is a very challenging process, and if done so inaccurately, it can push patients to switch medical providers. According to PYMNTS, 46% of unwell patients have canceled an appointment because of high cost estimates, and two-fifths of patients who received inaccurate cost estimates spent more on healthcare than they could afford. Healthcare providers and organizations have seen drastic reductions in payment as a result.
Understanding Why Patients Don’t Pay
According to research by Debt.com, 45% of Americans have outstanding medical debt. Some reasons why patients can’t pay their debts includes financial hardship (which can be from job loss), murky healthcare billing systems, unexpected billings (especially during the holidays), and ambiguities with insurance. Inflation isn’t helping the situation, with almost 60% of people forgoing healthcare due to higher living expenses across the board.
Unpaid medical bills and their resulting medical debt are typically the outcomes of a combination of factors. First and foremost are unexpected healthcare costs, which is precisely what it sounds like: unplanned and unbudgeted medical expenses. The continued hike in high deductible plans and increased out-of-pocket expenses has also hit healthcare consumers’ wallets.
Additionally, uncertainty around billing is an issue for patients who need clarification on their responsibilities, billing due dates, or even which providers they saw during their encounters. Finally, technology can be a barrier to patient payments. When patients can’t access, understand, or act quickly on their bills, they are less likely to make a payment or pay in full.
Improving the Financial Experience for Patients
Health systems and clinicians shape patient care experiences, which can unfortunately lead to medical debt and devastating consequences in certain circumstances. So, what can healthcare providers do to alleviate these financial pressures for patients and set them up for success beyond diagnosis and treatment?
The first and most obvious response is to get the bill covered by the carrier prior to sending it to the patient. With advanced technology partners, this is a goal that should and can be explored. However, if there is still a patient portion, the following four steps will enhance the experience for all:
• Patient Education and Awareness
Healthcare organizations can help individuals make educated decisions about how to plan and pay for their care. Enhancing medical billing transparency means ensuring patients are aware of out-of-pocket expenses, including cost-of-care discussions in provider-patient interactions.
With the federal No Surprises Act in effect, patients now have increased transparency into what scheduled medical encounters cost. However, these estimates can only be accurate if no unplanned medical care or treatment is needed during service. By communicating up front with patients about additional costs, they will be more empowered when making healthcare decisions.
Once a patient receives a bill, it should be accurate, easy to understand, and convenient for them to take action.
• Payment Choices and Flexibility
Healthcare organizations can help patients with medical expenses by expanding, simplifying, and innovating payment options and plans. Offering more ways to pay based on patients’ preferences is essential, as is giving patients more time and flexibility. No two patients are alike, and based on their propensity to pay, providers can offer patients customized communications that offer payments through paper, phone, text, email, or portal access.
Offering payment plans is a proven way to increase collection rates. Patients who are offered additional time, even if it’s just a few weeks more, are more likely to make payments or pay their bills in full, reducing likelihood of medical debt. By adding a few more weeks to the billing cycle, providers can offer patients a more dignified and effective way to pay for services at a time most suitable for their financial situations.
• Compassionate Care Continuum
Healthcare expenses are a source of anxiety for many patients. Intimidating collection steps won’t do them any good, but a more compassionate billing approach could help increase patient payments.
Team members should utilize compassionate language as they guide patients through their journeys. When patients are confused, they should be met with a responsive contact center that leads with empathy and understanding. After all, calm patients feel more confident in their billing and are increasingly more vested in paying for the services rendered.
• Simple and Streamlined Technology
Providers should implement portals that make it easy for patients to pay bills, schedule appointments, review payment plans, and share feedback. Empowering patients with a self-service option enables greater transparency and customized experiences — all leading to higher payment capture.
By developing an extensive and dynamic patient journey by persona, organizations can customize communications by patient demographics and propensity-to-pay. This allows them to use the most innovative, intelligent means to request and receive payment. If providers don’t have a portal that meets these criteria, there are technology-enabled revenue cycle services partners that can further enhance the patient experience.
No two patients have the same pain points when it comes to medical expenses. And considering the economic landscape evolves daily, healthcare needs to be ready to adjust accordingly. Providers need to find flexible and intuitive ways to connect with patients and offer a variety of payment options to engage compassionately throughout the entire healthcare journey.
Do you know the estimated revenue generated in 2023 from the healthcare industry will be around?$63.9 billion?The healthcare industry is extremely competitive, and survival is often challenging. Medical businesses spend around 10% to 15% of their revenue on medical practice marketing.This guide covers some of the best healthcare marketing ideas.
Why do you need marketing ideas in healthcare?
There was a time when medical practitioners and drug companies were fewer, and medical practice marketing meant word of mouth. But time has changed, and customers today are spoiled for choices that made the healthcare industry reconsider its marketing strategy. Marketers with innovative health promotion ideas can reach out to more people and retain existing clients.
When traditional marketing ideas for healthcare sound expensive, use the digital marketing space. It helps you connect with prospective patients and promote your medical practice at reasonable rates.
Top 5 marketing ideas for the healthcare industry
Listed below are the most creative marketing ideas in healthcare.
Artificial Intelligence (AI) has unlocked new possibilities that are pushing boundaries in healthcare. The U.S. Department of Veterans Affairs partnered with an AI company to create a system that diagnoses a deadly kidney disease up to 48 hours faster than a human could.
Virtual patients are utilized by medical schools, and Moxi the robot can be found in a Philadelphia-area hospital, performing non-clinical tasks so nurses can focus on their patients. The CDC says AI was even used as a research and public health tool at the height of the COVID-19 pandemic. AI advancements are quickly reshaping the healthcare experience for both the provider and the patient.
Beyond its critical uses in life-saving equipment, diagnosis, and treatment, AI can be harnessed to create innovative solutions on the administrative side — particularly through payment technologies. Let’s dive into three ways AI can improve healthcare outside the exam room.
AI can quickly analyze trends in a data set of payments to then create a database of typical charges for a given type of service or insurance. That would give patients — at the very least — a predicted range for the cost of an appointment or procedure. It wouldn’t be an exact number, but at least patients would have some sort of idea of how much money they will be spending. This would create more transparency between the provider and patient, therefore increasing trust in the relationship. AI is going to help the healthcare industry handle costs and payments in a clearer, more open way.
As we head into the new year, healthcare organizations will reevaluate their internal processes, procedures, and business plans to ensure they are ready to best serve patients and continue to operate successfully. There are many considerations and adjustments that are likely on the minds of organizational leaders based on aspects of the industry that have changed throughout the past three, tumultuous years. The new year is a prime time to assess the state of the industry and make shifts in processes for the betterment of overall patient care.
At SCALE Healthcare, we help healthcare organizations elevate their management performance and fine-tune their processes. Here is what healthcare organizations should keep an eye out for in 2023 and what internal considerations they may need to make to shift with the changing times in the healthcare industry.
The state of the industry
Today’s healthcare industry has been colored by what our world has endured since the onset of the pandemic, and many offices and organizations are still grappling with issues brought about by COVID. Cost and supply challenges continue to hamper the work that healthcare professionals can complete successfully. Problems with talent retention, the need for better invoicing and payment options, and the rise of healthcare IT technology advancements are all contributing to a rapidly evolving industry overall.
Women occupy 65% of the healthcare workforce yet seem to be missing in C-suite roles, holding approximately 30% of senior leadership positions and a mere 13% of coveted CEO titles. With female consumers making the majority of buying and usage decisions when it comes to healthcare products and services, the disparity between female leaders and end users in the industry is difficult to ignore.
In fact, we must pay attention to this gap that is slowly closing at a snail’s pace, as fortune 500 healthcare company boards slightly grew female leadership from 22.6% in 2018 to 26% the following year. And although U.S. hospitals tend to have more women at the top, a 2019 Rock Health report revealed that the metric of female representation is just over 37% in this arena. Certainly, progress is being made, but the diversity of welcoming women into leadership roles in all facets of healthcare – particularly healthtech – is crucial to meeting the diverse care needs of all patients and consumers across the board.
Diversity is a Must in the Industry
Spanning all industries, diversity is crucial at all levels of the workforce. Not only is it socially the right thing to do, but studies prove that a diverse workplace improves financial returns by 35%. Additionally, having a variety of perspectives boosts innovation, creativity, decision making, and opportunities to reach new customer demographics like never before.
Inclusive companies are almost two times more innovative and are better at making decisions 87% of the time. Similar to how diverse voices drive business outcomes, gender diversity is needed to continue pushing tech advancements in healthcare to deliver improved care for people of all backgrounds.
In the healthtech sphere specifically, women make up 20% of executive roles at the top 100 medical device companies. While many companies are hiring diversity and inclusion leadership roles to quicken the pace of change in the lack of diversity in healthtech, it’s crucial to share how gender diversity is taking control of the market and benefiting the industry. As a female executive of a telehealth platform with over 15 years of industry experience, I have seen significant growth as well as process and product improvements in our company – a company that is proud to possess a workplace culture that has been recognized by Forbes, Comparably, Inc. Magazine, Modern Healthcare, USA Today, and San Diego Magazine.
By Robert G. Hauser, MD, FACC, FHRS, chair of the Cardiac Insight, Inc. scientific advisory board.
A decade ago, my 72-year-old wife suffered a major stroke while we were attending a medical meeting in France. Fortunately, that country has excellent acute stroke care, the blood clot blocking blood flow to the dominant side of her brain was quickly dissolved by an intravenous drug. While in the intensive care unit, her ECG monitor revealed a short burst of a fast, irregular rhythm: it was atrial fibrillation, a rhythm that diminishes blood flow and allows blood clots to form in the heart. My wife had had no signs or symptoms of atrial fibrillation until that moment when she was suddenly paralyzed by a clot that dislodged from her heart and traveled to her brain.
My wife’s story is all too common. Undetected and untreated atrial fibrillation is a silent killer. In addition to stroke, it can weaken the heart by causing it to beat too fast. When the heart’s pumping function is weakened, patients may develop heart failure, and some suffer sudden death. The incidence of atrial fibrillation is growing as our population ages. Risk factors include obesity, diabetes, high blood pressure, and heart valve disorders. Women are particularly at risk because, compared to men, their atrial fibrillation tends to cause more severe strokes and worse heart failure.
Nearly all the consequences of atrial fibrillation can be prevented. But the key is early detection and treatment. In the case of my wife, the only way her brief bursts of atrial fibrillation could have been found is if she had worn an ECG monitor for some period of time.
What is the right period of time? Multiple studies have been conducted to assess the proper amount of time required to detect arrhythmias while achieving cost efficiency. For decades, the commonly held belief was that 24- to 48- hours was long enough. However, newer studies have found otherwise. For example, studies in Clinical Cardiology and Pacing and Clinical Electrophysiology concluded that seven days is the ideal length of time. A study in the American Journal of Cardiology found that, for all types of arrhythmias, diagnostic yield increased with a monitoring duration of > 48 hours. Among symptomatic patients, 92% of arrhythmias were detected by the 8th day of monitoring compared to just 47% during the first two days.
Researchers have found that the vast majority of clinically relevant arrhythmias can be identified by continuous ECG monitoring for seven days.
By Darren Ghanayem and Maria Turner, managing directors, AArete.
America boasts the greatest advancements in medical research in the world: more Americans have received the Nobel Prize in medicine than Europe, Canada, Japan, and Australia combined, which together have twice the American population. America has potential to lead the globe in cutting edge medical care, delivering service that is paid for fairly, accurately, and efficiently. It’s time our payer system caught up with our world-class talent and facilities.
The process of connecting the American healthcare ecosystem’s 3Ps (Payer, Provider, and Patient) has been marred with inefficiencies and inconsistencies. Nowhere is this more evident than in the billing area, where inaccuracies and disputes are commonplace. Resolving these issues is both time consuming and labor intensive—payers often have to jump through hoops to get to the real essence of a provider’s claim and translate accurately the real costs to providers and what to collect from patients. Such billing challenges, or even simple opacity, are not isolated instances—they are embarrassingly prevalent. A 2016 study by the Medical Billing Advocates of America found errors in three out of the four bills they reviewed.
These inefficiencies have added to a fractured, disconnected healthcare ecosystem; patients harbor animosity toward health insurance payers when they are billed more than they expected, while payers and providers are in constant dispute over reimbursement and shared payment arrangements. As a result, the tension can be felt across all constituents.
What’s behind these billing errors? Provider administrators sometimes enter incorrect procedure and diagnostic codes. A simple typo might exponentially increase the cost of the claim. For example, with a single misplaced or misread digit, an X-ray on an ankle might incorrectly register as an image of the blood flow to a brain. Many of these inaccuracies can be attributed to well-meaning human error—and payers need to develop strategies to combat these relatively benign mistakes. They must move forward and work together with providers, because playing the blame game harms every facet of the delicate healthcare ecosystem. But this doesn’t completely rule out the possibility of fraud. In some cases, providers have generated inflated revenue by intentionally using the wrong billing code (a practice commonly called “upcoding”) or incorrectly using modifiers to bypass the review process (e.g., the use of Modifier 59 to report distinct procedural services not normally reported together).
Gait is now recognized as the 6th vital sign and serves as a valuable indicator of health and mobility status. Previously, clinically-validated gait analysis technology was only available in lab settings, making it costly and inaccessible. With the development of new digital health technologies, providers can now collect objective gait and motion analysis data about their patients for heightened insight that enables them to better tailor treatment and provide proactive intervention when necessary.
What is there to learn from your patient’s gait analysis?
No two people walk the same way, which is why gait analysis has become a particularly useful tool for better understanding individual patients from a more holistic lens. Mobility status directly impacts how a person can interact with their environment and live a fulfilled life, which is why understanding and addressing functional mobility concerns is imperative for healthcare providers. Gait analysis is applicable across multiple healthcare sectors and can be used to:
Perform multi-faceted, thorough fall risk assessments
Establish a preoperative baseline and track postoperative progress
Understand the impact of disease on mobility
Highlight intervention efficacy objectively
Assess and predict risk for frailty
Leverage data for remote therapeutic monitoring (RTM)
Traditionally, objective gait analysis has only been performed in lab settings with expensive equipment. Observational gait analysis is more commonly used in clinical practice due to the lack of access to gait analysis technology. While observational analysis done by a trained professional can reveal important mobility data, it is difficult to quantify and standardize given the subjective nature.
By Pamela Gould, chief growth officer, 