The Evolving Patient Payment Landscape: Strategies for RCM Success

In next week’s HealthLeaders Winning Edge webinar, panelists will discuss the challenges to collecting patient payments.

Patients are taking on greater responsibility for their healthcare costs. Trends toward high-deductible health plans (HDHPs) and rising overall costs seem likely to continue in the foreseeable future.

This means health systems must rethink their approach to collecting patient payments to secure their financial health.

The shifting landscape creates considerable challenges for both patients and providers. Patients grapple with affordability and potential medical debt. Meanwhile, provider organizations pursue costly new technologies and tweak delicate workflows to optimize payment collections. Additionally, pricing transparency requirements like those found in the No Surprises Act add another layer of complexity.

On Tuesday, May 27, the next webinar in our Winning Edge series will tackle the challenges health systems face, and the strategies they adopt, on the road to patient payment success.

Our panel features:

• Ryan Klein, senior director of patient access and financial experience at UW Health;
• Mike Lorenz, director of revenue cycle at INTEGRIS Health;
• Andy Talford, senior director of patient financial services at Moffitt Cancer Center; and
• Eric Sulivant, solution strategist at Waystar.

Thinking of patients as payers

The growing prevalence of HDHPs is one culprit for growth in patient responsibility for healthcare costs. Enrollment in HDHPs increased from 20% of covered employees in 2013 to 29% in 2023, according to the KFF 2023 Employer Health Benefits Survey. 

In a bad sign for revenue cycle leaders, recent data from Kodiak Solutions suggests that collection rates after insurance payments have fallen as patient financial responsibility has risen.

To make matters worse, a growing share of patients say they are struggling to afford their healthcare bills. Only 55% of patients responded that they can afford their healthcare bills in a recent Gallup survey, a six-point decline since 2022.

This affordability gap suggests health systems may need to think about delivering more creative financing options to patients who are struggling to pay their bills.

Confusion over cost sharing

Part of the problem when it comes to patient payments is confusion over what is owed. Between inaccurate pricing estimates and a combination of premiums, co-pays, and deductibles built into health plans, patients often face difficulty determining what their financial responsibility is for the costs of care.

Three out of ten patients said it was somewhat or very difficult to understand their out-of-pocket costs when using health insurance, according to a recent KFF issue brief. This knowledge gap suggests provider organizations could boost patient payments by better educating patients on their financial responsibility for healthcare services.

Can technology bridge the gaps?

Patients usually want to pay their bills, but health systems sometimes stand in their way. While there is a lot of talk among revenue cycle leaders about expanding digital door fronts, many health systems are not offering consumer-friendly, tech-based tools that make payment experiences so much simpler in other industries, like retail and banking.  

The evolving patient payment landscape presents undeniable hurdles for both patients and providers. As patients grapple with affordability and complex cost-sharing, there is a clear need for a new approach from revenue cycle leaders.

Please join HealthLeaders for an insightful discussion on these topics and more during the upcoming Winning Edge on Patient Success.

Register here to reserve your spot.