A new report examines how the rise of consumer-directed health care, with patients assuming more financial responsibility for their treatments, will accelerate under health reform and soon compel new revenue cycle management processes and tools for providers.
The free report is from consultancy Boundary Information Group, which Citi Enterprise Payments commissioned to assess the impact of growing patient responsibility. Citi is testing a Web-based based portal called Money2 for Health, available via traditional and mobile computing devices, and expects it to be available in late 2013.
“Our research shows that physicians’ and hospitals’ ability to maintain cash flow and maintain and increase collection rates require a strategy to address the rapid shift to more self-pay responsibilities due to increased consumer choice of higher deductible health plans, and the potential widespread choice of health insurance exchanges with lower premiums and higher out-of-pocket amounts,” says Steven Lazarus, president of Boundary Information Group. “The trend is moving so fast that waiting is not an option. The new operating rules for HIPAA transactions, bolt-on third-party revenue cycle software products and provider portals are among the tools that have great value to address this shift in revenue sources.”
The consultancy interviewed more than 50 health care experts including ambulatory and inpatient chief financial officers, patient account managers and recognized thought leaders. “More than 85 percent of health care providers interviewed are in some phase of implementation or planning for improvements in their ability to address higher patient financial responsibilities more effectively,” according to the report. “Those initiatives include new processes and technologies including increased use of eligibility checks and financial estimation tools, and offering more flexible, digital payment options for patients.”
For instance, less than half of surveyed providers accept online payments today and patient portals account for a very small percentage of received payments. Providers have found patient portals help improve scheduling, communication with clinicians and access to clinical information, but have not yet frequently used payment functions. That activity, report authors warn, should increase dramatically during the next 18 to 24 months.
Most surveyed providers are purchasing or evaluating third-party software and services to handle complicated self-pay collections, and no single vendor currently offers an easy and comprehensive suite that meets their needs. But the providers are making major process moves as well, according to the report. “The majority of revenue cycle executives interviewed are placing new emphasis on staffing the front-end processes with the strongest revenue cycle employees in order to register and interact with patients, payers and perhaps employers. This is a different emphasis from the past, where previously the stronger and higher paid employees were in the back office.”
The report, “The Impact of Growing Patient Financial Responsibility on Healthcare Providers,” is available at boundary.net.
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