By: Christopher Wolfington

The Healthcare Bill Problem, Explained

What’s the worst part of healthcare for most consumers?

Undoubtedly, it’s when that massive bill ends up in your mailbox. According to Christopher Wolfington, founder of FinPay, there were $460 billion in out of pocket expenses for consumers last year. Of these bills received, only 19% of Americans paid their bill. This points to a fundamental flaw in the system.

The way the national healthcare system handles healthcare billing is complex and confusing. There is little in the form of education, transparency, and payment options – the opposite of what consumers want and need if they are expected to pay their bill. So, what needs to change for healthcare providers?

To begin, Christopher Wolfington says hospitals should look to alleviate the pressure and confusion that the consumer feels by starting the conversation prior to care. By engaging the customer about their financial responsibilities, and finalizing the discussion on cost and payment options beforehand, patients can focus on the clinical experience and getting well – which should be the priority of both patient and provider.

Not only this, but healthcare providers and hospitals need to realize that patients would benefit from a system that can guide them through the patient financial management cycle, including the payment process. Copays, deductibles, and co-insurance costs need to be identified and explained in a manner that is easily understood by patients, to reduce confusion and create a comfortable financial and clinical patient experience.

Wolfington believes the solution starts with patient payment analytics. By using historical data, FinPay identifies patient “situational risks” that routinely cause bad financial outcomes for the provider. This empowers providers to target & segment patients and provide an educational curriculum and payment options that are tailored to the patients’ specific situation. This is very similar to how population health targets & segments clinical risk. Though healthcare has a specialist for every type of clinical need, financially, the patient is left wanting.

As Wolfington states in a Sirius Business Radio interview with Karl Ulrich from LaunchPad, “An educated consumer is always going to be the best customer, and a comfortable, confident patient is better off clinically and financially.” Healthcare providers need to create a patient financial experience that mirrors the high quality clinical care patients are accustomed to. This is achievable by having a patient financial management strategy and process that is as disciplined, proactive, and comprehensive as a provider’s revenue cycle management strategy. This means the conversation on financial responsibility for healthcare costs should begin prior to care when customers are thinking like a patient and, like the clinical process, should involve education, transparency, and a review of all available options. This will make the customer's adoption of pre-care & point-of-care payments a positive experience for the customer and the provider.