Practical considerations for optimizing patient payment processes and performance…

When attempting to improve patient payment processing and collections, there are a number of challenges that healthcare provider organizations can face, including:

Technical: Technical challenges in adding, integrating and improving transactions processing to better meet the needs of patients and consumers, often in complex environments and with disparate systems.

Operational: Operational challenges in improving patient collections and revenue cycle workflows, improving “the ask” (i.e., knowing when and how to request payments) and improving customer experience in billing and collections

Strategic: Strategic challenges impacting business plans, information technology implementations, bond ratings and other key organizational initiatives

Revenue cycle, patient accounting and collections make up the financial engine of a healthcare provider organization—and payment processing is the fuel. Payment optimization initiatives can deliver tremendous value, helping healthcare systems compete in rapidly evolving and uncertain markets. And as patient payments increase as a percentage of net patient revenue, the ability to optimize patient collections and drive payments earlier in the process will take on even greater importance.

Trends and Challenges Impacting Patient Payments

When it comes to increased patient responsibility, there are a number of implications that healthcare providers should take into account, including:

Patient Payment Volumes: There has been an almost 200 percent increase in patient payment volumes—and over 300 percent growth in automated payments—between 2011 and 2014, with mobile payments expanding to more than 11 percent of all patient volumes. Since 2013, there has also been an 11 percent increase in the average ticket price, which now reaches almost $150.1 And patient payment volumes and dollar amounts will likely continue to grow, challenging healthcare providers to give their patients access to improved payments, pricing, billing and collections services.

High-Deductible Health Plan (HDHP) Risks: A 2015 Becker’s Hospital CFO article outlined the risks of HDHP plans for providers: “According to the National Center for Health Statistics, 36 percent of Americans under the age of 65 with private health plans are enrolled in an HDHP, and only one-third of those consumers are enrolled in plans linked to health savings accounts. With the out-of-pocket costs for patients increasing due to the popularity of HDHPs, and with so few purchasers taking advantage of savings plans, the risk of bad debts and charity care increases for healthcare providers.”

As the percentage of HDHP patients rises, climbing deductibles could strain patient finances—which means that providers will need to focus on improving collections methods, billing practices and patient payment optimization.

Patient responsibility, the popularity of HDHPs, and the total volume and dollar amount of patient payments will likely continue to rise in the coming years—and higher deductibles will require healthcare providers to use every tool available to address the needs and challenges of patient consumers.

“As patient payments increase as a percentage of net patient revenue, the ability to optimize patient collections and drive payments earlier in the process will take on even greater importance.”