Patient Financial Services



Shopping around for a deal is no new concept; consumers do it all the time, especially when making big-ticket purchases. But in health care, this approach just began gaining momentum over the last several years, notably following the onset of health care reform. As a result, many patients today are becoming selective health care consumers—evaluating their delivery of care options in many of the same ways they treat those big-ticket purchases.

So why are patients making these shifts in their health care buying patterns? And how can providers ensure their organizations are poised for success?

Increasing Patient Financial Responsibility
Increased cost-sharing and the resulting out-of-pocket costs are driving patients to become more engaged—and choosy—health care consumers. Patient out-of-pocket spending is cited around 30% to 50% of total health care costs, a trend that is being driven by enrollment spikes in high-deductible health plans.

  • 39% of consumers under 65 are enrolled in high-deductible health plans.
  • Nearly 25% of all health care consumers carry high-deductible coverage.
  • 90% of members enrolled in coverage through the health insurance market places are enrolled in high-deductible health plans.

That amounts to a large volume of patients that must shift their income around to cover health care expenses—in turn creating patients who are highly engaged consumers.

Accessibility to Health Care Information
Highly engaged consumers want information about the products and services they are purchasing. Technology delivers an unprecedented amount of information to patients at a rate like never before—ranging from topics about their own health to information about providers and plans. This is changing the way patients research their health care options.

The bottom line: patients have an abundance of information about their health care choices available to drive their shopping experience. And they are proactively looking for feedback from fellow consumers to guide that decision-making process—mirroring how they might choose a restaurant, make a car purchase or plan a vacation. This means the patient experience is more important than ever.

The Growing Importance of Patient Experience
As patients become true consumers of health care, they are increasingly demanding enhanced features of service that include convenience and transparency. This includes aspects of service that span the entire patient experience—from scheduling an appointment to delivery of care to payment collection.

Examining the patient experience from the perspective of a "customer journey" is one way providers can tackle the health care delivery experience to identify continued enhancements. For many patients, an exceptional experience will be a key differentiator that ensures they return for care in the future—a factor the influences your revenue streams.

Impact on Revenue Cycle Management
With the sharp increase in patients choosing high-deductible plans, the volume of payments providers must collect from patients is rapidly growing—and many have reported they anticipate collecting only 50% to 70% of a patient's balance after an episode of care.

Paying a health care bill is an unpleasant and extremely stressful experience for many patients, particularly when considering high out-of-pocket costs. Providers will be challenged to develop a process that ensures a convenient and positive patient experience while ensuring timely receipt of payments. Self-service, online payment and up-front payment options, along with a seamless uninsured screening and enrollment process, can make this a positive experience for both patients and providers.

As health care evolves and patients become even more selective, consumerism will continue to become an increasingly influential factor in patients' health care choices and provider growth.