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Analysis

Why Patient Billing Woes are Clinicians' Problem, Too

By Alexandra Wilson Pecci  
   August 22, 2019

Clinicians and patients say medicals bills are a 'distraction' from patient care.

Billing worries don't just plague patients. They can also affect clinicians, too.

New research conducted by HIMSS in partnership with OODA Health finds that two-thirds of clinicians said dealing with patient collections takes time away from patient care.

It shows that 65% of clinicians say that are frequently or occasionally distracted by clerical/financial tasks that limit or take time away from patients.

Providers also reported that bills distract their patients from properly following care instructions.

They said 44% of patients are frequently distracted by bills and payment concerns, resulting in a lower level of compliance and adherence to medical plans. Thirty-six percent of patients are occasionally distracted by bills.

The research included surveys with 37 providers from U.S. hospitals/health systems and 27 respondents from health insurers/payers/health plan administrators.

It also found:

  • 67% of providers use patient collections to justify rate increases during payer negotiations
     
  • 85% of payers report that member satisfaction drives benefit design, at least to a moderate extent
     
  • 63% of payers report they want greater insight into how plan complexity is experienced by the member
     
  • Payers do not know what portion of medical bills are paid by patients
     
  • 74% of payers say that having actual consumer payment data would improve their models

"Provider billing is mapped to contracting and billing relationships, not to how the patient experiences care," Seth Cohen, president and co-founder of OODA Health, said in a statement. "From a single hospital visit, a patient could receive five or six bills, depending on their providers' contract and billing relationships."

OODA Health recently gave HealthLeaders details about its plans to expand its real-time healthcare payments pilot program with Dignity Health.

Among the program's elements is allowing patients to "receive a single bill, rather than multiple disparate bills, from all the providers involved in a single inpatient stay," said Sophie Pinkard, OODA Health's cofounder and head of product.

Alexandra Wilson Pecci is an editor for HealthLeaders.


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