One-third of health insurers did not meet the January 2014 mandate to support electronic funds transfer and electronic remittance advice transactions. And, about one-fifth of consumers have unpaid healthcare bills because of a confusing payment process.
Those are some of the insights in the fifth annual report on U.S. healthcare payment trends from claims clearinghouse InstaMed. The report vividly shows the payment pressures that providers are facing both from insurers and patients.
Despite the high number of insurers not yet supporting EFT/ERA, many insurers were offering EFT prior to the compliance date; EFT payments from insurers to providers increased 169 percent between 2011 and 2014. Also in January 2014, 17.4 million healthcare consumers were enrolled in high-deductible health plans, a 12 percent increase in just year.
In addition, as insurers reduce their payments as consumer payment responsibility rises, InstaMed handled a 193 percent increase in direct consumer payments to providers between 2011 and 2014. During 2014, consumers spent a total of $824 billion for healthcare services, according to the Centers for Medicare and Medicaid Services. The clearinghouses own network saw an 11 percent increase in the average amount a consumer paid to a provider between 2012 and 2014. Average deductibles for healthcare consumers increased 50 percent since 2009.
Consumers are paying greater amounts of their medical bills with a card; these types of transactions represented 81 percent of gross dollar volume payments on InstaMeds network in 2012 and 85 percent in 2014. With most providers now accepting card payments, they also are adopting other convenient ways to pay, as automated payment plans increased by 314 percent between 2011 and 2014. Mobile payments also are up sharply in recent years. In 2011, two percent of payments via the clearinghouse network were made from a mobile device and that volume rose to 11 percent in 2014.
The clearinghouse calls on insurers to ease payment processes. More than 90 percent of consumers want to pay their healthcare bills online and about 80 percent believe insurers should let them make all payments in one place, according to InstaMeds research.
Premium. Deductible. Co-payment. Do consumers really know the difference? Do they understand? For most, the answer is a resounding No, according to the report. To effectively engage consumers, health plans must focus on effectively communicating payment responsibility to consumers and making it easy for them to payregardless of the payment channelall in one place like an integrated payment portal.
The Trends in Healthcare Payments Fifth Annual Report 2014 is available here.
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