Sadly, for many people, patient experience is a matter of life and death. Every decision made in the healthcare sector (whether it’s how frequently a patient should be seen, or when to administer treatment) has an impact far beyond that decision point. And every provider, naturally, wants the best outcomes for their patients. Achieving these outcomes requires consideration of every aspect of the patient experience — from the bank to the bedside.
It’s no secret that finance is a key concern within the healthcare ecosystem. For patients, it’s a question of how they’ll pay for their care; for providers, it’s a question of being able to collect without damaging the relationship with their patients. Currently, due to a combination of internal and external factors, payment and collection rates are at unsustainable lows. On average, providers are currently able to collect only 19% of outstanding patient balances. The stakes are high, here. Thankfully, we have the privilege of offering a solution.
It’s pre-care patient engagement, which is exactly what it sounds like: engaging patients to educate them on financial obligations on the front end of their healthcare journey, before they’ve received their first services. When implemented correctly, this approach goes a long way towards improving financial outcomes for patients -- and, conveniently, for providers too.
FOR PATIENTS, PRE-CARE ENGAGEMENT...
Enables strategic financial planning
Paying for healthcare can feel like playing catch-up. So many patients have had the experience of coming home from the hospital to a bill (or bills) they didn’t expect, and not being able to shoulder the unanticipated expense. Negotiating coverage with insurance companies can be incredibly time-consuming and often unfruitful, particularly when it has to be done after the fact.
But what if these expenses could be predicted? What if providers could help patients understand the costs associated with every stage of their healthcare journey? What if patients could plan for these charges; better yet, what if they could make financially-conscious decisions about care?
What if the only thing they had to worry about was getting better? What if providers could focus only on helping them?
This is the single most important benefit of pre-care engagement. Transparent conversations at the outset of care mean fewer — or no — surprises along the way. They allow providers to counsel their patients on the best courses of action, and for those patients to be strategic and proactive about their upcoming expenses associated with their recommended care plan.
Topics that should be discussed in the pre-care setting include (but are not limited to)
- Additional coverage opportunities
- Payment plans: scheduling, adherence, and options for simplification (like automation)
Allows for essential education
There are many variables to consider when making financial decisions about health. Patients have to navigate insurance benefits, health savings accounts, government assistance, and so much more, all in the context of their personal financial status and goals. Getting the right care shouldn’t be a question of costs -- but, in these circumstances, it can feel like a leading factor to patients’ decisions on healthcare.
This big, seemingly unanswerable question can and should be answered earlier. In all cases, informed decisions are better decisions. Engaging patients prior to care is an opportunity to educate them about their options in a manner suited to their individual situation and financial literacy. Some will have more questions; some will have more options; all will benefit from personalized up-front education.
Empowers patients to take control of their care
There is little that’s more stressful than having to navigate the United States healthcare system. Unanticipated costs, complex insurance policies, and other complications can feel incredibly disempowering, particularly in the moments of a health crisis.
Pre Care patient engagement is an opportunity to restore ownership of care to patients. Instead of reacting to challenges as they arise, patients who’ve been engaged prior to care can take a proactive approach to the journey ahead. In a safe environment with a counselor, patients can ask questions, discuss options, voice frustrations, and relieve any other up-front anxieties. With all the information, they can approach their journey with more confidence; with their questions answered, they can rest assured that they’re prepared for the challenges ahead -- financial and otherwise.
FOR PROVIDERS, PRE-CARE ENGAGEMENT...
Builds trust in patient relationships
We all know that first impressions matter. As it turns out, last impressions do too.
Providers have so many opportunities to engage with their patients. There’s pre-care, the care regimen itself, follow-ups, and post-care case management. Why not make the best of all these interaction points, leaving patients with the final impression that, as a clinician, you’re best-equipped to deliver?
That impression is the clinical one. As a provider, your focus should be on care, not billing for it, which can be sensitive and fractious. Even the best patient care could be overshadowed by an unpleasant billing experience, leading to a negative impression of your practice and, potentially, consequences to your overall satisfaction score.
In fact, under governance implemented by the Center for Medicare and Medicaid Services (CMS), patient satisfaction plays a role in determining reimbursement eligibility. Recently, CMS also finalized additional governance regarding price transparency. As of January 1st, 2021, hospitals will be required to publicize payer-specific negotiated rates for certain services. Hospitals that do not comply with this governance could face financial penalties and be identified as noncompliant.
The best way to avoid these consequences is to have financial conversations at the outset of care, doing your part to head off surprises and prepare patients for the road ahead. Pre-care engagement allows your final impression to be clinical, not financial, as payment plans will already be in place and coverage questions will already be answered. Building space for these conversations prior to care also helps to establish trust in patient relationships. Patients will associate your practice with transparency, proactive disciplines, and easing their burden, leading to increased trust and a greater likelihood patients will turn to your hospital, and or health system, when faced with a health crisis.
Absolves providers of burdensome revenue management
Revenue management and collections are equally as cumbersome for providers as they are for patients. Just as patients have to navigate a wide range of financial variables, so too do providers; from CMS governance to managed care contracted insurance reimbursements, there are many complex variables at play. It certainly doesn’t help matters that each patient experience is likely to have its unique challenges.
As discussed above, providers’ and patients’ time is best spent engaging with patients, not collections agencies or governing bodies. Pre-care engagement separates the disciplines of patient financial management from revenue cycle management by designating an appropriate window in which financial conversations should take place. Patient experiences will always vary, and there will always be complexities to unravel. Having these essential conversations prior to care allows for proactive implementation of management strategies, as opposed to reactive hours spent trying to figure out next steps.
Allows for more accurate financial predictions
Patients are hardly the only group to benefit from increased financial transparency. When they are equipped with an understanding of what they’ll owe and when they’ll owe it, as well as a comprehensive plan for meeting those obligations, they are far more likely to submit their payments. In fact, data shows that patients counseled prior to care on FinPay’s platform are able to meet approximately 83% of their payment obligations, with 54% collected before services are rendered.
The benefit to your bottom line is clear. Educated patients are empowered to pay their bills — and, with the right planning and utilization of automated payment services, their payments are much easier to predict and track. Just as engaged patients can plan for the road ahead, so too can providers who are confident in their patients’ ability to meet financial obligations.
Pre-care engagement is an effective financial management framework for both patients and the providers who serve them. The practice absolves patients of the uncertainty associated with paying for care, and providers of the burden of managing unpredictable cases. Given the changing healthcare landscape, as well as the high stakes involved with any care decision, proactive management strategies are more essential than ever.