The latest webinar in The Winning Edge series features a discussion among leaders from UW Health, INTEGRIS Health, and Moffitt Cancer Center on strategies for improving pre-service collections and navigating the complexities of accurate pricing estimates.
As patients’ share of their healthcare costs has grown, revenue cycle leaders are focusing on two front-end revenue components: securing pre-service payments and providing accurate cost estimates.
In the latest webinar for HealthLeaders’ The Winning Edge series, four revenue cycle experts shared how they are rethinking patient payments and working to create more accurate cost estimates.
Here is what 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, had to say during the May 27 event, sponsored by Waystar.
The Importance of Pre-Service Collections
Collecting patient payments upfront is becoming a clear priority at many health systems.
"There's a longstanding tradition or culture of patients receiving medical bills after services are provided,” Klein said. “And we all know that's changing dramatically."
The need for a proactive approach has become more clear as patient out-of-pocket costs rise. Moffitt has tried to move as many conversations about bills to the front of the process as possible, according to Talford. The intent is to have “patients start their journey with a pretty good idea of, ‘Here’s what I owe.’”
For self-pay patients, Moffitt creates cost estimates and requires a deposit before treatment begins, underscoring the commitment to securing pre-service payments among a population where bad debt has traditionally been an issue.
UW Health has a similar policy, according to Klein. When patients are checking in, whether on the phone, in person with frontline staff, or on a self-serve kiosk, they are required to either pay in full, set up a payment plan, or apply for financial assistance. Automated payment plans have also been a huge success.
"Having those automated payments on a monthly basis makes a huge difference and reduces the amount of effort that our teams are having to do when it comes to outreach,” Klein said.
The Persistent Hurdle: Delivering Accurate Pricing Estimates
The ability to provide patients with accurate pricing estimates is critical to collecting payments upfront, but it is also a task fraught with challenges.
Part of the difficulty is that each payer and plan has its own benefits and policies. Lack of standardized, reliable benefit information is one significant barrier to creating accurate pricing estimates, according to the panelists.
However, there is an inherent variability in pricing for many healthcare procedures that also complicates estimates. This unpredictability, especially for procedures where the scope is unclear, makes it difficult for healthcare to mirror fixed pricing that consumers experience in other industries.
Lorenz compared healthcare services to a mechanic’s services to highlight how much more difficult it can be.
“There may be things [that] arise during surgery that, unlike your car, they can't call you and ask how you’re going to go ahead and do this because it's going to be an extra $5,000,” he said.
While revenue cycle leaders are making strides in shifting collections to the pre-service stage through technology and process changes, the ability to consistently provide accurate pricing estimates remains a significant challenge.
Luke Gale is the revenue cycle editor for HealthLeaders.
KEY TAKEAWAYS
Collecting patient payments upfront is a growing priority, with some health systems requiring payment before services are rendered.
Accurate pricing estimates are critical to upfront payment collections, but challenges persist.