Consumer-Centric Tools Improve the Revenue Cycle

Two health systems have improved payments by making healthcare payments mirror consumer experiences and by tapping the growing popularity of crowdfunding websites for healthcare bills.

Most hospitals and health systems claim to be patient-centered, but they don't all put their money where their mouth is when it comes to helping patients access and pay for care.

I've spoken recently with finance leaders at two health systems that are implementing tools that take the consumer perspective on bills, improve the patient experience, and in turn, boost the revenue cycle.

Patient-centric billing and payment

When Laurie Hurwitz became the executive director for revenue cycle at La Crosse, WI-based Gundersen Health System about a year ago, she was determined to simplify the system's billing and collections processes.

At that time, Hurwitz says, patient statements were difficult to read because they were payer-centric, not patient-centric. She worked to remove the healthcare industry jargon and increase readability for the average person.

"I was interested in finding a better solution for the patient. I wanted it to be easy for them to immediately understand what they owe and what they need to do to pay," Hurwitz says.

"I care more about the patient experience than I do about collecting from the patient, which might sound strange coming from a finance person, but I believe one follows the other. If we don't do what is right for the patient, I believe it will impact us financially."

The next step in Hurwitz's plan to "delight the patient" was to implement a simple, technology-driven way for patients to pay their medical bills—an idea she says stemmed from her own desire for the easiest way to complete tasks.

"I'm lazy. I walk around with a five-inch computer with me, and I want to do everything with it. I don't want to write a check. I don't want to go anywhere. And I think a lot of people my age are that way, and certainly my kids and their friends are that way."

With that in mind, Hurwitz led Gundersen's transition to a new billing process that offers self-service payment options via email and the MyChart patient portal in its electronic health record. The new billing methods were rolled out across 36 locations in five months.

"[We] launched a new billing experience designed to engage patients earlier with more transparent and friendlier information and offer easier and more flexible means to complete payments on their own. The simplified process is intended to mirror the types of experiences people have as consumers, supporting the overall goal as a patient-centered healthcare system," Hurwitz says, noting that the system has adopted self-service payment as a new success metric and now measures patient billing satisfaction.

The early results are significant. Gundersen has experienced a 132% rise in payments coming in through a self-service option and a 13% decrease in cost per statement. Additionally, in a patient satisfaction survey, 76% of patients indicated they would recommend Gundersen due to their recent payment experience.

Hurwitz believes patient convenience is increasingly important to the future of provider organizations.

"I'm concerned when I look at people in the next generation. … When I look at my kids who are in their mid-30s, I see people who have no loyalty. They want what they want when they want it, and if it's not convenient for them, they are going to go somewhere else. It's important in healthcare that we provide what the patient is expecting."

One of the positive "unintended consequences" of Gundersen's new self-service payment strategy is it shows staff that leadership is committed to changing the system's business practices to better meet patients' needs, she says.

"This sent a very clear message that we are not going to do things the way we have done them in the past. It's transformative."

Sponsoring crowdfunding campaigns for healthcare bills

At Harrisburg, PA-based PinnacleHealth System, senior leaders are trying to tap into the growing popularity of crowdfunding websites such as GoFundMe and Kickstarter.

In January, the system launched its HOPE Card program to help patients pay large medical bills associated with chronic illness, surgery, and other expensive procedures through online donations.

With the HOPE (Helping Others Pay Expenses) Card, patients work with a third-party vendor to create an online fundraising profile, which allows friends, family, and community members to make monetary contributions. PinnacleHealth sponsors the patient by paying the card's annual fee for the first year, and the vendor takes an administrative fee of 6% from the donations to maintain the individual website.

One main goal of the HOPE Card is to ensure that patients do not forgo healthcare due to an inability to pay, says William Pugh, PinnacleHealth's senior vice president and chief financial officer.

"It gives patients and their families a little bit of peace of mind that they will be able to pay their medical expenses. It helps them to get their drugs so they are more likely to stay on their medications," he says.

"They are also more likely to go to their follow-up appointments and get their tests done. From that perspective, it's really about patient care, comfort, and convenience."

By aiding patients in paying their bills, Pugh says, the HOPE Card will also likely improve collections for PinnacleHealth, which is dealing with a substantial increase in high-deductible health plans in its market in recent years.

"We are seeing growth in high-deductible health plans, both in the number of plans and the size of the deductible. When we first started seeing high-deductible plans, it might have been $1,000 for an individual and $3,000 for a family, but now it's increasingly up to $5,000 or $6,000 for an individual."

The HOPE Card is a tool to combat this sharp surge in patient financial responsibility, Pugh says, and positions PinnacleHealth as part of the patient's economic support system.

"We want to help individuals meet their financial obligations to the extent that we can in order to reduce the cost to collect, our bad debt write-offs, and our charity care," he says.

"We provide significant financial assistance to people above our charity care guidelines, but they still have some out-of-pocket costs, so they are good candidates for this program. Our intention is to help get those accounts paid and, hopefully, to reduce our write-offs."

And while it's too soon to know what the real impact on collections will be, Pugh says he and the leadership team at PinnacleHealth are optimistic.

"We are monitoring it closely. We did a soft launch in January and now we are doing some marketing and advertising … and we plan to keep pushing it. It's about the numbers. I would love to see hundreds of patients using it. We have large cancer programs and large transplant programs, and I think the growth potential and the financial upside is pretty significant. We're excited about it."