Patients Becoming Consumers

Healthcare is a basic necessity for all, but it is often an added expense that millions cannot afford. Providers continue with efforts to lower costs for high-quality care, but patients still face the bulk of the financial responsibility for their care. Consequently, patients are becoming active consumers. Providers now face the feat of catering to these new consumers while remaining successful.

High Deductible Health Plans

Price is a constant concern even as more patients are able to afford healthcare. High deductibles are one of the core reasons the healthcare payment hassle and the number of employers offering their employees this option is increasing. The Kaiser Family Foundation’s 2015 Employer Health Benefits Survey found the number of employees enrolled in high deductible health plans increased from 13 to 24 percent from 2010 to 2015.

43 percent of patients with high deductible healthcare plans reported their deductible as burdensome and 40 percent of patients with high deductible plans have avoided going to a physician if sick, skipped a follow-up test, forewent preventative care or failed to get specialist care because of their high deductible.

Patients as healthcare shoppers

Patients are now consumers, carefully shopping for high quality, low-cost healthcare. April Sackos, Vice President of Revenue Cycle Management with Meridian Surgical Partners claims patients are looking for transparency in cost and quality and want to compare providers in an attempt to make the most cost-effective decisions.

How ASCs can remain relevant

Ambulatory surgery centers (ASC) have long been considered low-cost, high-quality, but this reputation could change if surgery centers do not adapt to the current healthcare environment. “As patients take on a greater share of their healthcare costs, ASCs may see an increase in bad debt and a decrease in utilization,” says Ms. Sackos. ASCs can apply the following tips to preserve the bottom line and offer patients access to the care they are seeking.

1. Employ a rigid benefits verification system. Establish a strong system for verifying patients’ benefits, and use this system to generate a cost estimate for patients. Answer questions patients want to know: How much will the patient’s insurance plan cover? How much will the patient be expected to pay?
2. Communicate financial expectations. Once a patient’s financial obligation becomes clear, share these expectations with the patient prior to the procedure date. Openly communicate clear, up-front expectations for payment. If payment in full is not being collected prior to the date of service, present a clear plan for payment after the patient’s discharge. Ms. Sackos claims open communication with patients regarding payment is the most important indirect driver having an impact on your bottom line.
3. Offer financial guidance from professionals. Healthcare payment can be confusing even for those working in the industry. Eliminate much of the confusion by offering patients access to financial counselors. A medical billing and coding professional can be essential to explaining healthcare payment to patients and employees.

Employees should be educated and updated on constantly changing patient payment and healthcare plans. The MEREM Healthcare Solutions medical billing experts can help maintain the appealing high quality, low-cost care patients are looking for. If you would like to learn more about our billing and monitoring services, contact us today.