– Sean Joyce
Most health system executives will agree there’s no shortage of data in the healthcare industry. The problem is knowing what to do with it. In just three years from 2016 to 2019, healthcare organizations saw the volume of health data increase by 878%. Despite the abundance of data, bridging information silos and extracting useful insights that improve patient workflows remains a challenge.
Advanced data analytics and greater connectivity present opportunities for health systems to automate processes, minimize revenue leakage and create a better patient financial experience.
In the wake of COVID-19, the health systems that act on these opportunities will gain a head start on their financial recovery from the pandemic, so this begs the question: what’s holding the revenue cycle back from translating data into meaningful insights for better decision making?
What are the hurdles?
Healthcare organizations spend multi-millions of dollars on clinical and financial IT systems each year. Yet, those systems often create a disjointed experience for patients and revenue cycle teams because they aren’t truly integrated and therefore, the data remains in silos.
Today, it’s common for large health systems to have multiple electronic health record (EHR) systems, along with separate systems for scheduling patients, generating price estimates, checking a patient’s insurance eligibility, offering affordable payment plans and more. Essentially, every touchpoint is often powered by a different software product with its own data silo.
Also, many healthcare IT companies have merged and therefore “bolted together” solutions via acquisitions to create their product offerings. For example, conventional patient payment companies typically “bolt together” portals and billing statements that only minimally connect to the underlying payment technologies.
As a result, there’s rarely a single source of truth for patient financial activity. This can lead to discrepancies in what the patient sees on their bank statement and what the revenue cycle team sees. As a result, it’s difficult for revenue cycle teams to work with patients and address their financial needs while ensuring the health system gets paid for the services provided. Even worse, the breakdown in information does irreparable harm to the trust between the patient and the health system.
What needs to change?
To make data more reliable and actionable, revenue cycle teams need an integrated payment platform that connects data from various sources and creates a truly patient-centric experience.
An integrated payments platform acts as an information hub between different IT systems, including the EHR, estimator tools, insurance information, and more. Think about it this way – before smartphones, you left your house with your wallet and keys, plus you had a map, GPS (miss you, Garmin), notebook with a list, or written directions to your destination.
Today, you just carry your smartphone, which provides directions, contact information, lists, and even your credit card information for contactless payments. An integrated payments solution consolidates information the same way your smartphone consolidates your personal items. Patients can view their up-to-date bill balance, review a price estimate or their payment history, sign up for payment options that match their personal financial needs, message their provider and more – all from one place.
By leveraging an integrated payment platform that consolidates data from multiple enterprise systems, healthcare organizations make it easier for their patients to understand, manage and pay for healthcare expenses. This data creates the foundation for a personalized and adaptive experience that empowers patients to confidently navigate the financial responsibilities associated with their care while improving revenue cycle outcomes for health systems.
Why act now?
Healthcare billing and payment experiences continue to be leading sources of frustration for patients. According to Patientco’s 2020 State of the Patient Financial Experience survey, when paying healthcare bills, four out of five patients have felt confused or frustrated. Patients have felt confused and frustrated for various reasons, from the lack of upfront pricing before treatment to receiving multiple bills after one visit. Meanwhile, over one-third of patients have been frustrated because it was difficult to understand what their insurer covered.
Patients are also concerned about the cost of their care. In fact, patients often defer necessary medical care over financial concerns – 45% have delayed medical care or skipped it altogether over concerns about their out-of-pocket costs. While such concerns about healthcare expenses are not new, the COVID-19 pandemic and the economic recession that followed has amplified them.
Many of the frustrations felt by patients are actually the result of point solutions that health systems rely upon for various revenue cycle processes such as scheduling, cost estimates, and eligibility. With so many siloed systems, patients don’t know which source of information to trust. Patients get overwhelmed trying to figure out the nuances of why they owe what they owe and make sense of their financial obligations. Ultimately, they become disconnected from the health system and patient loyalty is compromised.
Meanwhile, for busy RCM teams, responding to confused patients who have questions about their financial responsibilities can seem daunting, manual, and time-consuming. Health systems employ hundreds of team members to handle high volumes of manual tasks, such as answering patient phone calls, responding to email and patient portal messages, accepting, and posting payments and more.
As a result, when patient visit volumes grow, so does the workload for these team members. There is an opportunity for technology to streamline these tasks, so team members can focus on other efforts and enable the health system to care for more patients without significantly increasing operational costs. Realizing this opportunity is key, especially following the COVID-19 pandemic as many health systems will have a backlog of elective procedures to reschedule.
Technologies, such as chatbots with natural language processing and personalized self-service payment options can empower health systems and their team members to focus more on patient care and less on administrative tasks. For instance, if a patient is anxious about the cost of their care and has a question about their price estimate, the patient can easily be guided by the chatbot to a personalized view of the cost information they need including easy instructions on enrolling in an affordable payment plan and links to self-service scheduling. This all takes place with no added burden on the health system’s team members. However, these technologies require an integrated payments platform and advanced data analytics.
What Does Success Look Like?
With a payment platform that consolidates data across different systems, healthcare organizations can personalize each patient’s financial care in a scalable way. At the same time, this makes data actionable and enables revenue cycle team members to better assist patients navigate their financial options.
Health systems can leverage data including a patient’s preferred communication, such as email or text, along with other data, like bill balance amount and prior payment history to tailor outreach and payment options to each patient. For example, health systems can encourage a patient who has a large bill balance to sign up for a payment plan with messaging on their bill and influence a patient with a smaller balance to pay in full with a prompt payment discount.
Data that’s consolidated and actionable allows health systems to predict the best ways to drive patient engagement, proactively meet patients’ preferences and give patients an easy way to manage their current and future expenses with tailored, self-service affordable payment options. This also empowers team members to offer better support when patients need assistance most.
Collectively, by doing this for all patients in a health system, health systems use what traditionally was transactional data to outline a better, more tailored financial experience that delivers meaningful financial results for their organization.
About the Author
Sean Joyce is Patientco’s chief technology officer (CTO) and is responsible for the ongoing product, engineering, and innovation initiatives for Patientco’s patient financial engagement platform. For over 15 years, Sean has focused his career on enhancing the consumer healthcare journey across all stages of engagement with a health system.
Prior to Patientco, Sean launched the first advisory software for small businesses navigating the Affordable Care Act as a product leader within ADP’s TotalSource business. Earlier in his career, Sean built software at startups that pursued his passion for detangling the complexities of healthcare through technology. Sean received his B.S. in Computer Science from Eastern Michigan University and his MBA from Emory University.