5 Key Trends in Healthcare Payments

In its fourth annual report on trends in healthcare consumer payments, claims clearinghouse InstaMed finds stark evidence of the growing impact of high deductible health plans on the industry. Consumers are receiving more health care bills and paying larger amounts.

About the Report About the Report

InstaMed is a major processor of electronic claims and related transactions, serving more than 1,500 hospitals, 60,000 practices and 100 billing firms, and linking to more than 3,000 payers. Provider findings primarily reflect physician practices. Analysis of the data during 2013 shows that the annual number of patient payments to providers rose 72 percent between 2011 and 2013, and the average payment of $110.86 in 2011 increased 20 percent to $133.15 in 2013.

Out-of-Pocket Soaring Out-of-Pocket Soaring

The company notes that Americaís Health Insurance Plans, a payer trade association, expects out-of-pocket expenses for insured patients to rise from $250 billion in 2009 to $420 billion by 2015. Consequently, providers increasingly are offering payment plans; InstaMedís data shows that the number of annual transactions for payment plans increased by 284 percent from 2011 to 2013.

Electronic Payments Electronic Payments

More providers are accepting card-based electronic payments and more patients are willing to pay this way. Card payments represented 42 percent of the gross dollar volume of back office payments in 2013, up 8 percent in two years. Insurers also are increasingly paying providers electronically. Those using the InstaMed network to disburse electronic payments increased their volume by 66 percent since 2011.

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Payment Problems Payment Problems

An InstaMed survey of providers that complements the data analysis shows 67 percent of respondents saw an increase in patient payment responsibility in 2013. Forty-two percent of provider did not know patient responsibility during the visit, 76 percent said it takes more than a month to collect from a patient and 56 percent pegged collections as the top revenue cycle concern.

Payer Sentiment Payer Sentiment

The vendor also surveyed health insurers, finding that half of respondents in 2013 did not yet support new HIPAA operating rules for more standardized electronic funds transfer and electronic remittance advice transactions. Compliance was mandated by January 2014. Of payers that offered ERA/EFT last year, 60 percent indicated that less than half of providers accepted the electronic transactions. Many providers preferred paper payment and remittance, or could not receive electronic transactions, or were unaware of the transactions.

Consumer View Consumer View

An accompanying survey of more than 200 consumers finds that 72 percent of respondents were unaware of their payment responsibility during a visit. Only 2 percent received healthcare bills via email in 2013. If given the option of how to pay healthcare bills, most indicated they would pay online via a provider, payer or bank Web portal. The vendor reminds providers that mobile devices also can be used to collect payments at the point of service.

More Information More Information

Full survey results areavailable here. Registration is required.

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In its fourth annual report on trends in healthcare consumer payments, claims clearinghouse InstaMed finds stark evidence of the growing impact of high deductible health plans on the industry. Consumers are receiving more health care bills and paying larger amounts.

 

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