For a long time, many American workers qualified for and took advantage of insurance plans that covered most or all medical expenses, save a co-pay or reasonable deductible. Paying for healthcare wasn’t an engaging process for consumers, who knew that insurance would take care of the bill on their behalfs.
In the past few years, that traditional paradigm has been flipped on its head. Patients are now more responsible for covering their own medical bills. In 2015, 24% of all workers were enrolled in a high-deductible healthcare plan, as compared to just 8% in 2009. With consumer-directed care on the rise, in large part due to steep hikes in the cost of healthcare, it’s the responsibility of patients to follow through on paying for their medical visits.
The way that high-deductible healthcare plans (also known as HDHPs) work is that consumers enjoy lower premiums at the expense of (obviously) higher deductibles. Many of these plans are paired with tax-free Health Savings Accounts. Basically, the high-deductible plans offer coverage in case of medical emergencies -- but for more typical medical care, consumers are responsible for paying.
According to the Kaiser Family Foundation, 81% of consumers have a deductible they must pay themselves before care is covered through their insurance plans. That kind of staggering growth presents new challenges for healthcare providers, who now have to focus on collecting from consumers as opposed to insurance companies.
Called healthcare consumerism, this new model relies on giving the customer the ability to pay without hassle. As a result of healthcare consumerism’s prevalence in the modern medical landscape, key changes need to be made within your collection process to maximize revenue.
Eligibility verification needs to be implemented
Patients who can’t afford to pay or don’t have insurance coverage bring collection rates down and leave care providers footing the bill. Verify that a patient is eligible prior to rendering care, and save yourself the cost and hassle of tracking down a payment later on.
Information needs to be accessible to healthcare consumers
Consumers need to trust that a provider is charging them a fair rate, and may want to shop around. Being candid about providing pricing information delivers the transparency that today’s patients crave. Arming consumers with necessary information helps them make decisions.
Paying needs to be as easy as other consumer transactions
Here’s the good news about patient payments: Patients are willing to pay their bills. In fact, 90% of patients will pay out-of-pocket expenses of up to $500 per year, while 74% are willing to pay twice that. If you’re set up to collect right away, you can take advantage of that consumer intent. Practices need to give the consumer the ability to self-engage with the payment process. Making it easy to provide payment information up front will increase the amount of payments you receive.
While insurance companies aren’t going to be eliminated anytime soon, the radical market shift in who foots the bill for medical care means that practices and ambulatory centers need to be more strategic in pursuing patient payments in 2017 and beyond.