Becker's Hospital Review

48 Executive Briefing Sponsored by: 1 InstaMed, Trends in Healthcare Payments Eighth Annual Report: 2017, May 2018 2 CareCredit, Healthcare Payments Benchmark study, December 2017 3 InstaMed, Trends in Healthcare Payments Eighth Annual Report: 2017, May 2018 I t's become clear that the payment shift is not a short-term phenomenon, and patients are likely to continue being directly accountable for a significant portion of healthcare costs. One recent study projected out-of-pocket spending on healthcare expenses will surge to $608 billion by 2019, an increase of 46 percent in just five years (up from $416 billion in 2014). 1 The causes for this increase are numerous and complicated, including rising enrollment in high-deductible healthcare plans; increasing premiums, deductibles and overall healthcare spending; and even demographic and societal factors like an aging population, rising obesity rates and the opioid epidemic. While patients are bearing the burden of higher costs directly, providers are paying a price as well. A survey of healthcare practices in the CareCredit acceptance network found providers' number one concern related to billing and collections was the length of time it takes to collect payments, and on average, 14 percent of balances owed ultimately go uncollected. 2 Data from Instamed confirms this challenge, with 58 percent of surveyed providers citing patient collections as their top revenue cycle concern; 73 percent reporting it takes a month or more to collect patient payments; and 33 percent saying they write off more than 10 percent of patient collections each year. 3 These statistics illustrate what may be an inevitable realization related to the payment shift — traditional financial models are no longer optimal in today's healthcare environment. For many healthcare organizations, policies and processes were developed in an era when collecting from third-party payers was the focus. Now that more patients are assuming greater responsibility for payments, institutions and individuals alike need to adapt. Many solutions exist to help patients make payments and manage costs or to help providers with collections and revenue cycle management. For example, offering third-party financing can allow patients to move forward with recommended care immediately and pay over time, while saving providers time and effort related to billing. Avoiding treatment delays and declined care — and allowing providers to focus more on patients rather than paperwork — can contribute to better outcomes and increased satisfaction all around. Even so, simply deploying a new solution isn't enough. It is important to acknowledge the payment shift and communicate with staff and patients in a spirit of transparency and collaboration. Doing so may seem uncomfortable at first, but it provides an opportunity to increase patient engagement and satisfaction, improve employee confidence and advance your organization's business goals. Define and document The first step to implementing a new approach to patient payments is defining that approach. Start by considering what's not working well today. Is your organization struggling to collect balances due, investing more time and effort and waiting longer to collect less? Are staff members unclear when to request payment and in what amounts? Are they uncomfortable discussing financing and payments with patients? Are patients unhappy because they're receiving unexpected bills for balances due, having to pay more up front or unsure what they owe and when? Are practices inconsistent, with staff members handling billing and payments in different ways for different patients? The answers to these questions can help you identify areas to address in new policies and processes. Once you make these decisions, it is vital to document them. Creating financial policy documents can help clarify your thinking and make it easier to share and implement new processes. You'll also have a reference when questions arise and a living document you can update if it needs to change. Communicate and reiterate The next step is to communicate your new policies to the appropriate parties. This includes staff members who will help implement the policies, patients affected by them, other stakeholders in your organization and possibly key partners or referral sources. Written communication can work well for many audiences, and providing access to financial policy documents is important. In addition, in-person conversations are recommended to introduce the new policies to staff, especially those expected to play a key role or make significant changes. Group meetings can work well to discuss new policies, why they are needed, Patient engagement in the out-of-pocket era By Dave Fasoli, Synchrony EVP and CareCredit CEO

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