3 Ways Hospitals Can Help Patients Handle High Out-of-Pocket Costs

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The Affordable Care Act created a drastic shift in patient cost and insurance reimbursement for hospitals. To counteract this, Revenue Cycle Solutions recommends three ways hospitals can help their patients handle higher costs and help themselves by getting their revenue cycle get back on track.

Hospitals can help their patients (and themselves) by empowering patients with information to make informed financial decisions.

In our current health system, patients are facing higher deductibles and higher out-of-pocket costs. Individuals with health insurance through their employer have seen their average deductibles rise sharply from $303 in 2006 to $1,077 in 2015*. Additionally, nearly 90% of insurance plans purchased through the Health Insurance Marketplace have deductibles over $2,000**. Due to higher cost and regulatory changes, patients are more focused than ever on making informed financial decisions regarding their medical services. Hospitals can help patients and help themselves with:

1. Estimates: Patients should receive an estimate of their out-of-pocket costs at least three days prior to a scheduled service, when possible. According to a 2014 TransUnion Healthcare survey, “8 in 10 Americans report that upfront cost estimates would have a positive impact on their decision to continue using a provider." However, the same survey revealed that nationally only 25% of patients received an estimate without asking for it***. In addition to patient satisfaction, advanced estimates can help reduce AR balances, bad debt, and expenditures associated with billing.

2. Payment Options: Hospitals need to make it easy for patients to pay by offering multiple payment options. Payments should be convenient with online payment portals or smartphone applications. Increase incentive for patients to pay with cash, check, or credit by offering discounts for paying in full or in advance. Additionally, payment plans are crucial, as 42% of Americans say they have more difficulty affording healthcare than other household expenses****. Engage patients early with their options, ideally in advance of their scheduled service, so payment is more likely.

3. Informed Staff: Knowledgeable staff is the key component to help patients with medical expenses. It is imperative that hospital registration and billing personnel are educated and can clearly explain out-of-pocket expenses to patients. Staff should be well informed on the basics of the Affordable Care Act, Medicaid, and the hospital’s charity care policy in order to provide patients with appropriate resources. Patient inquiries concerning medical expenses should always be answered promptly and accurately.

‘We’ve seen hospitals attempting to provide patients with estimated out-of-pocket costs prior to rendering services,” said Daniel Thiry, Managing Principal of Revenue Cycle Solutions, “yet they are focusing on the collection of payments rather than empowering patients with information to make informed financial decisions.” Patient anxiety over medical expenses can be greatly reduced when an estimate is provided, payment options are offered and a knowledgeable staff is there to help.

*2015 Employer Health Benefits Survey. (2015, September 22). Retrieved November 3, 2015, from The Henry J. Kaiser Foundation.

**June 30, 2015 Effectuated Enrollment Snapshot. (2015, September 8). Retrieved November 3, 2015, from CMS.gov Centers for Medicare & Medicaid Services.

***Neal, B. (2014, June 19). New Findings on Consumers' Views of Billing Experiences and What They Mean for You. Retrieved January 4, 2015, from TranUnion Healthcare.

****DiJulio, B., Firth, J., & Brodie, M. (2015, October 28). Kaiser Health Tracking Poll: October 2015. Retrieved November 3, 2015, from The Henry J. Kaiser Family Foundation.

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Bill Poole, Principal
since: 08/2015
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Revenue Cycle Solutions, LLC

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