By Noel Felipe, SVP-Operations & Practice Leader, Firstsource, April 2021
The patient mindset is changing. They search for the best price to be sure, but they’re also seeking out the best financial experience.Specifically, they’re looking for the same experience from Healthcare Providers that they receive from companies outside the healthcare market.
Shifting Consumer Behaviour
According to research 1 findings by NTT DATA Services, 59% of consumers expect the digital healthcare experience to emulate their favorite online retail experiences, like those provided by Apple, Amazon and Google. When it comes to their healthcare financial experience, they want an all-in-one platform that allows them to communicate, pay bills, and manage financial matters using mobile phones, personal computers, and tablets. They want a seamless experience, intuitive interactions, instant answers, and the flexibility to conduct business at times convenient for them.
Patients have become consumers, slowly transforming the healthcare industry into a
consumer-driven market. Unfortunately, the healthcare industry has fallen behind when it comes
to what consumers want most: exceptional digital experiences. A recent survey 2 found that Healthcare Providers are significantly behind other industries when it comes to technology. For example, only 18% of large hospitals and 6% of smaller hospitals have automated their corporate services functions.
Constraints to Collect
Changes in the healthcare system have altered the relationship between patients and the healthcare
industry. A decade ago, Providers worked chiefly with health insurance companies to recover payments. Now, patients are the third-largest payer behind Medicare and Medicaid. And although patient co-pays and deductibles have been increasing between 6% and 8% year after year, Providers are not the beneficiaries of those rising numbers. 3
On the contrary, higher deductibles have led to more medical debt for consumers. The result for Providers is slower payments and unpaid bills. In fact, 70% of Providers indicate that it takes more than a month to collect from patients, and nearly one-quarter of working-age adults have past-due medical debt. 4
Rising deductibles are shifting medical costs to patients, making it harder for patients to meet their out-of-pocket expenses, and in turn, putting Healthcare Providers at financial risk. According to the Kaiser Family Foundation research, 5 the average annual deductible among covered workers has increased 36% over the last five years and 100% over the last 10 years.
COVID-19 couldn’t have come at a worse time. Healthcare organizations are battling lower insurance coverage and reduced elective procedures, leading to increased revenue pressures. The need to reduce staff, especially when many Accounts Receivables (AR) processes are performed manually, is further constraining healthcare systems already stretched thin.
As uncompensated care grows by leaps and bounds, it’s clear that Providers must do something different.
Digital Patient Engagement
A digital patient engagement solution offering includes self-pay collections and communications (letters, texts, etc.), ability for patients to make payments, update insurance, review statements, file disputes, and more.
These digital solutions enable Providers to address several of the critical challenges they’re currently facing. For one, implementing tested digital solutions that enable the Revenue Cycle Management process to continue functioning is key to maximizing eligibility screenings, qualifying patients for Medicaid, and efficiently collecting patient responsibility.
Plus, the digital solutions alleviate the need for in-person interactions while continuing to provide the
same level of co-operation, engagement, and communication with patients that is typical in a face-to-face setting. The solutions enable Eligibility Services employees, Point-of-Service Collection
associates, and even hospital registrars to support patients offsite while also eliminating the need for
layoffs or staff reductions.
The latest advances in digital solutions for patient engagement can help you accept more varied forms of payment, post patient co-pays as soon as possible, and calculate complex deductibles to avoid the most common payment delays at the end of the claims process. Moreover, a POS collection module that is part of a robust RCM solution can connect more information upfront throughout a department or across the enterprise.
Combine Robotic Process Automation with analytics
Deploying Intelligent Automation combined with the human touch can dramatically reduce the effort to collect balances and increase ROI.
Intelligent Automation helps digitize every aspect of the healthcare revenue cycle management (RCM) process by blending Robotic Process Automation (RPA) with Artificial Intelligence (AI) and advanced analytics.
At the front-end, automated eligibility workflows ensure appropriate upfront data to inform patients of their obligation to prevent or minimize loss of revenue. At the backend, the digitized workflows route denials to the right collections team, at the right time, for rapid resolution.
Integrating claims and contract management, unifies data, streamlines the process, and provides next-best actions, increasing collector efficiency, driving down the cost to collect, and elevating patient satisfaction.
Advanced analytics empowers users across three major areas:
- Pinpointing the root cause of small balance write-offs.
- Unlocking insights into hidden data by drilling down into claims, reviewing aging claims and identifying gaps in the revenue cycle process to better manage cash flow.
- Identifying the likelihood of payment on outstanding balances.
Revamping core RCM infrastructure for sustained success
RPA in healthcare, in conjunction with AI and analytics, can help streamline the end-to-end cycle – from Patient Access to Mid Revenue Cycle to Patient Financial Services. The result: lower revenue cycle expenses and enhanced ROI for a healthy bottom line.
While COVID-19 has disrupted the way the world runs today, it has also paved the way for faster adoption and acceptance of technology, especially around IA. Organizations that had already started their digital transformation journey were better positioned during the pandemic than others. Organizations that were earlier unsure about adopting Intelligent Automation are now evaluating and looking to drive organization-wide programs to adapt to the changing business environment.
Forward-thinking Healthcare Providers that recognize today’s reality and understand the limitations of their current processes have the opportunity to become industry leaders in the next decades. By aligning their financial services engagement strategy with patient expectations, they can create a satisfied and loyal customer base and enhance their ability to care for communities long into the future, all while optimizing their ability to recover net revenue.