Health iPASS Insights

Are Inefficient Patient Revenue Cycle Practices and A Lack of Price Transparency Damaging Everyone's Health?

Posted by Allyson Howard on May 13, 2018 3:03:05 PM

medic-563425_1920As a kid who was fascinated by science and machines, I was delighted to learn about the concept of the Rube Goldberg machine. If you don’t remember what a Rube Goldberg machine is, watch this video depicting a Rube Goldberg photo booth. I promise, you will be enchanted! A Rube Goldberg machine is defined in Webster’s Dictionary as “a comically involved, complicated invention, laboriously contrived to perform a simple operation.” These machines are often characterized by a long series of actions that finally loop around to complete a small task such as turning the page of a book or pouring breakfast cereal into a bowl. Rube Goldberg machines are classic fodder for the school science fair, intended to educate children about machines and entertain onlookers.

Unfortunately, there is nothing entertaining about the complicated, often labyrinthine functions of the patient revenue cycle. And while the comically involved functions of Rube Goldberg machines typically lead to the intended outcome, it is hard to say the same of the patient revenue cycle. 

Ostensibly, the purpose of the healthcare industry in general is to promote the health and well being of patients. The patient revenue cycle now has more impact on the ability of medical providers to offer quality care because of the sharp rise in High Deductible Health Plans (HDHPs) which are directly tipping the payment scale to a larger portion of overall revenue. Medical Providers are placing more emphasis on ensuring they can collect patient payments to support their sustained ability to quality deliver care and services. 

When the processes of patient revenue cycle management are inefficient, none of the intended purposes of quality healthcare can be achieved. Rather, medical providers fail to collect the revenue they need to stay in business, patients accrue piles of bad medical debt, and ultimately, the health and well being of many communities suffers.

You may be thinking that the previous statement seems to be a stretch—but consider this: according to a 2014 Gallup Poll, 1 in 3 Americans don’t get the healthcare they need because of how much it costs. These costs refer not only to the actual costs themselves, but the psychology of not knowing what the costs will actually be. According to a 2017 Kaiser Health Tracking Poll, 45% of Americans said they’d have a difficult time paying an unexpected $500 medical bill. The fear of healthcare costs especially affects preventative care measures because people don’t go to the doctor until the healthcare issue has become too serious or painful to overlook.

For medical providers, the time and costs associated with the collection of patient payments can decrease their ability to provide quality service and care for their patients. In addition, as patient retention becomes a growing concern, medical providers must seek ways to improve the patient experience that builds trust and promote loyalty. Any impediment that keeps doctors and medical staff from interacting positively with patients and patients from seeking preventative care must therefore be removed. 

While opinions are mixed on whether preventative care drives down the cost of healthcare overall, it is an undisputed fact that preventative care improves quality of life

According the Center for Disease Control (CDC), 

When we invest in prevention [preventative healthcare], the benefits are broadly shared. Children grow up in communities, homes, and families that nurture their healthy development, and adults are productive and healthy, both inside and outside the workplace. Businesses benefit because a healthier workforce reduces long term health care costs and increases stability and productivity. Furthermore, communities that offer a healthy, productive, stable workforce can be more attractive places for families to live and for businesses to locate.

Reduced costs, healthier children and communities, greater stability and productivity--seems like a no-brainer, right? Clearly it is imperative that the healthcare industry must encourage patients to seek preventative care in as many ways as possible. Effective revenue cycle management and higher price transparency are ways to accomplish this because they have the potential to benefit patients, providers, and the healthcare industry overall by removing the obstacle of unknown and unanticipated healthcare costs that may otherwise push healthcare consumers away from preventative care. 

In order to achieve the end goal of healthier lifestyles that include appropriate preventative care, providers can start by taking steps to demystify the revenue cycle, make it easier for patients understand and pay medical bills, which should include the ability set up payment plans, and support greater price transparency. Even a seemingly small adjustment such as adopting effective revenue cycle management tools will lead to a streamlined patient revenue cycle from appointment to final payment which in turn helps support healthier communities. Overly complicated revenue cycle management is no laughing matter, but simplifying the process is something everyone can smile about.

Topics: Financial Transparency