Developing a patient-centric model for transparency and payment helps take the stress out of managing the costs of care, enabling patients to focus on their health. (Getty/utah778)
by Mark Spinner
Source: www.fiercehealthcare.com, December 2019
At a time when family health coverage costs as much as an economy car, consumers need upfront information on out-of-pocket costs and extended payment options—and they’re willing to switch providers to get it.
Two in five consumers say they would switch providers to access affordable payment arrangements to cover their costs of care, including half of households with children, an AccessOne survey found. Meanwhile, 59% say providers’ willingness to share out-of-pocket costs prior to service is a critical factor in determining where to seek care, including 69% of Gen Xers.
What’s driving this mindset? Even as consumers seek lower-cost settings of care to decrease their out-of-pocket expense, 59% of consumers carried out-of-pocket healthcare costs of $501 to $1,000 dollars in 2018, up from 39% the year before, according to a TransUnion survey. That’s because average inpatient, outpatient and emergency department costs rose 12% from 2017 to 2018, according to TransUnion.
How can providers most effectively satisfy increased demands for transparency and affordability in a rising-responsibility environment? Here are three strategies to consider.
1. Make it easy for consumers to find cost information
Transparency around costs ranks high among consumers in evaluating a provider, with an emphasis on providing cost information before a procedure (59%) and publishing pricing lists for common procedures (39%), survey results show. Meaningful price transparency is critical: Consumers want to know their anticipated out-of-pocket costs before they arrive for care, taking into account the insurer’s negotiated rate, co-pays and the portion of the deductible met to date.
List the prices for common procedures on your website and share the patient’s anticipated out-of-pocket costs prior to the point of service, such as during registration. Leading organizations provide this information in patients’ preferred communication format, whether by phone call, text (with a link to a secure portal), email or postal mail.
2. Start patient financial discussions early
Don’t wait until after care has been provided to initiate discussions around payment. Provide out-of-pocket costs prior to the day of service, where possible, and engage patients in discussions around their ability to pay for their care. Explore whether patients are concerned about how they will manage their out-of-pocket costs and assess whether a payment plan is needed.
Addressing cost concerns in advance holds strong generational appeal, given that 45% of Generation Xers worry about their ability to pay for an unexpected medical expense under $500 and 80% of millennials want to discuss payment options in advance. It’s an approach that also strengthens the patient financial experience, the first and last encounter patients will have with your organization.
3. Look for ways to offer increased flexibility around payment
Consumers who don’t feel prepared to manage the costs of their care are more likely to postpone treatment, with 56% delaying care due to concerns around costs—26% for a year or more, according to survey responses. When it comes to payment options, one size does not fit all. Presenting a variety of payment options enables patients to pay with dignity, no matter their financial circumstances. One best practice: Give patients the flexibility to adjust payment arrangements if monthly payment amounts become too much to handle.
A compassionate approach to care
Consumers bear an enormous cost burden in a rising-rate healthcare environment, and it’s changing their behavior in a way that impacts market share, core consumption of care and, ultimately, clinical outcomes.
Developing a patient-centric model for transparency and payment helps take the stress out of managing the costs of care, enabling patients to focus on their health.
Mark Spinner is CEO and president of AccessOne, a leading provider of flexible, co-branded patient financing solutions that help patients afford medical expenses for health systems nationwide.