Providers face challenges in getting patient payments

Patient financial responsibility for their healthcare services has skyrocketed since 2015, with increases of nearly 30 percent in deductibles and out-of-pocket costs, making healthcare providers scramble to implement new processes and information technologies to ensure payment for services.

The average deductible in 2017 is $1,820, with average out-of-pocket costs of more than $4,400, based on a Black Book survey of 2,698 providers and 850 healthcare consumers with high deductible health plans.

The survey covered 1,595 physician practices, 202 hospitals and 49 delivery systems, with 82 percent of physicians and 92 percent of hospitals looking to abandon manual processes to reconcile bills.

In today’s environment, “patients truly are the new payers,” says Doug Brown, managing partner at Black Book. More providers this year are establishing funding mechanisms that benefit themselves as well as consumers, he adds.



In the first half of 2017, 62 percent of bills were paid online, and nearly all surveyed consumers indicated they would pay online if their provider offered the service. More than 70 percent of consumers said mobile payments and billing alerts offered by a provider increases their satisfaction with the provider.

Also See: Best practices from HFMA on talking to patients about payments

But consumers want more services, such as online estimation, payment plan administration and on-demand instructional support, all of which give more transparency to consumers. “Guest pay,” such as enabling family members, attorneys or others to pay a consumer’s bills without having access to the medical record also is improving satisfaction. Further, these online services aid providers through faster posting and collection of payments with fewer errors, Brown notes.

Many providers, however, have catch-up work to do before online services can be offered. The survey revealed that while 89 percent of provider financial administrators expect to have mobile payment technology available by late 2018, only 20 percent are currently ready for electronic payments.

Providers also are hampered by the difficulty that health insurers face in giving current data to providers on patient deductibles. Some 83 percent of surveyed ambulatory providers say they often estimate payment responsibilities incorrectly at the time of service.

Black Book also asked provider survey respondents to rank their revenue cycle management vendors on 18 performance indicators. Navicure was the most preferred vendor and others ranking well included Experian, Patientco, Change Healthcare, InstaMed and nThrive.