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Cost Transparency Is Patient Payments Starting Point







If the point of healthcare revenue cycle management (RCM) is creating processes that get providers paid in full more quickly, we may be entering a belle epoch of patient payment options that chip away at the mountain of bad debt many healthcare organizations are sitting on.

As more FinTechs and other players tap into a sector that the Centers for Medicare and Medicaid Services (CMS) estimates at $6.2 trillion by 2028, RCM is meeting patient payment preference halfway with new payment and credit solutions customized for health expenses.

According to Shannon Burke, senior VP and general manager of Health Systems at Synchrony, “We’ve totally gone past patients as payers. That’s kind of passé.”

“What I’m seeing more is revenue cycle and management understanding that patients are customers. Our expectations as a patient who is a customer are different. Just like any other area of our lives, we want to be treated with respect and flexibility, be able to pay the way we want to pay and have options — and obviously very little friction in the entire process.”

This has everything to do with experience — as most things do today — and patient experience is more delicate than most.

“What we’ve seen is that the financial experience is as important as the clinical experience to patients today,” Burke told PYMNTS.

See also: 33% of Consumers Have Opted out of Needed Medical Care Over Cost

Bad Surprises, Good News

Much of the problem with healthcare billing and payments arises from the impenetrable nature of pricing in the sector.

“I usually don’t get my shoes, wear them around and then get asked by the shoe store to pay for my shoes,” Burke quipped.

In healthcare, you generally get the shoes, use the shoes, then get a giant bill for an amount that was never even hinted at — much less agreed to and budgeted for — for the consumer.

She said, “We don’t want to be surprised. We want to know what that cost is, we want the security of knowing that we can pay and that we have options to pay. It’s really making sure early in the process of my care that it is transparent to me and that when the time comes, I have options. Options like Synchrony’s CareCredit allow for a patient to be able to pay over time.”

The government agrees, and passed the No Surprises Act in 2021, with Department of Health and Human Services (HHS) Secretary Xavier Becerra saying in a statement that “no patient should forgo care for fear of surprise billing.”

According to Burke, a proliferation of patient counseling and other information about medical expenses before care is going a long way toward preventing this, as is a shift to pre-care and point-of-care payments. Major providers and insurance companies are leading the way.

Acknowledging that “it’s tricky to know what your cost is going to be,” she said, “even an estimate is a vast improvement over not knowing anything.”

See also: CareCredit CEO: Better Patient Billing Improves Doctor-Patient Loyalty

Patient-Customers Want Payment Options

With healthcare payments transforming beneath our feet, RCM is playing a critical ongoing role parsing new data feeds as part of the invisible experience.

If patients are customers, then healthcare providers should offer their finest product — health — along with ways of paying for that care, the cost of which is typically steep.

According to The Payment Cure: How Improving Billing Experiences Impacts Patient Loyalty, a PYMNTS report with research sponsored by Synchrony, a survey of over 3,500 U.S. adults, “The most commonly cited reason patients choose payment plans or third-party financing is to help them manage their budgets.”

In that study, 41% of respondents said alternative payment plans helped them handle their other bills or expenses, and that “interest in alternative payment options among consumers is significant: 45% of all patients would be interested in using these kinds of payments in the future and 26% report that they are ‘very’ or ‘extremely’ interested in these options.”

That’s where solutions like CareCredit’s healthcare financing need to be brought into the flow of billing, but also much earlier in the process. And everyone in the office should know about it.

“The RCM leaders have known for a long time that the earlier you collect in the cycle, the better you’re going to get paid,” Burke said. “There’s always been this idea that we need to collect and collect early. What has changed is the education: everybody in the office, including clinical staff, physicians and nurses, have to be at a minimum aware of financial obligations and impacts to the patient, and be prepared to be able to speak to it on some level.”

“The problem is growing,” Burke continued. “There’s going to be continued [attention to] bad debt. We’re doing the right things, but there’s still more to come because the wave of what you and I are going to owe for our care is not going to get smaller. There’s a growing need for support.”

Get the study: The Payment Cure: How Improving Billing Experiences Impacts Patient Loyalty



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