Becker's Hospital Review

61 Executive Briefing: Billing and Patient Satisfaction A irlines often send their passengers off with a cheery an- nouncement along the lines of "We know you have a choice of carriers, and we thank you for choosing us." Will the same spiel become a staple of hospital customer service de- partments? In leading healthcare organizations it is. Today, about 30 percent of Medicare payments to hospitals are based on quality or value — and the portion of these payments based on HCAHPS patient satisfaction scores is set to rise from 1.5 percent in 2015 to 2.0 percent in 2017. This direct link between patient satisfaction and revenue will likely become stronger because the HHS has set a goal of linking 90 percent of Medicare payments to quality or value by 2018. i In many ways, Medicare's value-based payments are one symp- tom of a much larger trend that is sweeping across the health- care system. Hospitals are increasingly focused on improving the patient experience and increasing patient satisfaction. They are hiring chief patient experience officers and teams of people to improve their HCAHPS scores. Why? Because in an era of in- creasing competition and consumerization, hospitals need to think about patient loyalty the same way other consumer-facing industries have for decades. As patients become increasingly empowered to make health- care decisions — and increasingly responsible for paying the bill — hospitals cannot afford for discharged patients to sim- ply leave the hospital healthy. Patients also need to feel good about the experience so that, the next time someone in their family needs medical care, they will return to the same facility. The average patient influences more than $1.5 million in life- time hospital expenditures for his or her household, ii so one dissatisfied patient puts a significant amount of revenue at risk. The implications for hospitals' financial health are so clear that a recent study found patient experience and satisfaction is the No. 1 priority for healthcare executives. iii There is no doubt the "consumerization of healthcare" is occur- ring. The new era of increased focus on quality and satisfaction, entry of new competitors into the healthcare delivery space and the changing economics of care require a focus on promoting patient satisfaction in the revenue cycle and new metrics for as- sessing effectiveness. The billing-satisfaction connection Hospitals have a persistent problem with patient satisfaction related to billing, and therefore, it is a natural place for man- agement to focus. The billing experience has a clear, direct and strong influence on overall patient satisfaction, especially be- cause it is the last interaction a patient has with the provider and thus is the "last impression" that influences the patients' likeli- hood to return to that provider in the future. The influence is not usually positive — patient satisfaction ratings fall by an average of more than 30 percent from post-discharge through the billing process. iv Billing in the healthcare system is so notoriously complex that patients not only have low expectations that bills will be ac- curate, but they also have a reduced sense of responsibility for paying them. Forty percent of patients do not pay medical bills simply because they do not understand them. v Hospitals shouldn't assume that their patients who do pay are satisfied customers — 81 percent of patients report anger or frustration related to medical bills. vi As a result, there is a growing movement to extend patient ad- vocacy services to help patients navigate through billing and in- surance processes. Savvy health systems are targeting the billing process because they see it as an area where they can harvest low-hanging fruit for improving patient satisfaction. Short-term, fi- nancial advocacy services improve revenue recovery, and longer term efforts help build patient loyalty, leading to recommenda- tions and return visits. Patients who are satisfied with billing are five times more likely to recommend the hospital than those that are not. vii Applying patient advocacy to improve billing satisfaction Although patient advocacy is commonly associated with care delivery, it can easily be extended to billing practices to help improve post-discharge satisfaction. Patient advocacy helps manage patient expectations, which in turn reduces the misun- derstandings that result in dissatisfaction. Patient advocates have successfully been used prior to care delivery to explain to patients their insurance benefits, check the physician status in the insurer's network, confirm treatment authorization, ensure the patient has realistic expectations for Patient Satisfaction and the Revenue Cycle: Improving the Billing Process to Generate 'Net Promoters' for Your Organization By Kelley Blair, Executive Vice President, Adreima, and Isabelle King, Director, Consumer Engagement, Adreima Sponsored by:

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