According to a recent survey, 84 percent of U.S. consumers say there needs to be a more streamlined payment system for healthcare, while 40% say they have missed a medical bill due to a complex payment system.
“When it comes to their financial experience, patient expectations are changing,” says John Talaga, EVP & GM of Healthcare at Flywire. With the average hospital bill nearly $1,000, Talaga says it is no longer enough to create an online payment portal.
Below, Talaga explores four ways hospitals can create meaningful financial interactions with patients.
Q: You have stated there are four key elements for driving a true financial journey for patients. Can you share them?
Talaga: Yes, but first it is important to understand that an affordability crisis is driving the healthcare consumer’s financial journey today. Patient liability now comprises a much greater share of a hospital’s overall net patient revenue due to high-deductible health plans, which is causing some consumers to avoid care altogether. Downstream, this also impacts a provider’s ability to collect. Unfortunately, the pandemic has accelerated the problem and is driving a new level of urgency for hospitals to address the patient financial experience.
The first step in optimizing the patient’s financial journey is to modernize the payment experience and make it easier and more affordable for patients to pay. Hospitals need a software platform that uses AI and machine learning to aggregate patient data across the network, including demographics, historical payments, and external data such as credit bureau information and credit-to-debt ratio. This technology is critical for predicting a patient’s capacity to pay.
Second, it is essential to personalize each patient’s financial experience. This is achieved by identifying patient conversation profiles and engaging patients in the manner they prefer to interact, including by email, text, chat, or even paper. The third principle involves matching each patient’s capacity to pay with their conversation profile and a financial offer that is tailored to their needs. Lastly, providers should complete the machine learning loop by measuring outcomes. For example, did the patient pay in full, did they need a payment plan, or did they default? All these things inform the next interaction.
Q: The biggest roadblock in the patient’s financial journey is the ballooning cost of care. How do the four principles help solve this problem?
Talaga: Consumers typically do not budget for healthcare services. On top of that, almost half of Americans can't pay a bill in one lump sum. Given that patients are now paying nearly 30 percent of overall charges compared to just 10 percent a decade ago, taking a one-size fits-all billing approach and just sending a bill isn't going to drive collections. The four principles address these concerns by automating and personalizing the patient’s financial journey upfront. During registration, a hospital can leverage a machine learning platform to offer personalized payment options to patients. This makes it easier for patients to pay in advance and helps them feel more comfortable that they have the right payment plan before they receive care. We call it patient-friendly billing 2.0. Helping patients understand what they owe and offering them personalized payment options increases their capacity and willingness to pay.
Q: Meeting patients with the right message in the right place at the right time is almost as important as the offer itself. How can hospitals leverage digital engagement to drive adoption and payments?
Talaga: We recommend hospitals adopt a sophisticated digital financial engagement strategy, leaning heavily on analytics and advanced engagement technology such as omnichannel. It’s really about using machine learning to monitor different modes of patient communication and understanding the type of messaging that works best for each patient. Having a frictionless and mobile first design is also critical. For example, frictionless design could mean sending patient texts or emails with pre-authenticated links to reduce log-in complexity. Pre-authenticated links help hospitals understand where patients are coming from while removing barriers to make it easier for patients to make a payment when they get to the site.
Q: Can you share a client story that helps illustrate where these four principles have come together to create a better financial journey for patients?
Talaga: We recently helped a $28 billion IDN improve the patient financial journey by standardizing patient billing across 100 hospitals in five markets with five different EHRs. This organization was managing patient billing in a traditional way, sending statements every 30 days. They had different online experiences and statement designs and were not using text or mobile to engage patients.
Applying the four principles we created one standardized payment platform across all markets and EHRs, applying analytics and offering patients different modes of communication, personalized payment plans, and a consolidated financial experience. Patients now receive one bill per month with one balance. The results have been incredible. Our client has seen a significant increase in patient payments, going from zero to more than 80 percent of patients using self-service payment plan activations. Patient satisfaction also increased dramatically. Importantly, health system leaders say the new system’s flexibility to adapt rapidly was critical in helping patients experiencing financial strain during the pandemic.