The Rapidly Shifting Patient Financial Journey and Key Considerations for Health Systems

From planned to unplanned healthcare costs, the uncertainty around paying for care has become a significant factor delaying many from getting the treatment they need when they need it.

In healthcare, the patient experience is rapidly converging with the modern consumer experience. Like other aspects of life, patients now expect a fast, intuitive purchasing experience when it comes to their care. Across the country, hospitals are responding by adopting price transparency, seamless touchless payment options and telemedicine platforms to increase access. As the landscape shifts, so do costs. And as we emerge from the COVID-19 pandemic, there are opportunities to build a positive financial experience for patients.

The first step toward advancing solutions is identifying potential barriers. From planned to unplanned healthcare costs, the uncertainty around paying for care has become a significant factor delaying many from getting the treatment they need when they need it. According to a Gallup poll, approximately 33% of Americans said they or a family member postponed medical treatment in the past year due to cost. While many adults delayed care due to fears during the pandemic, those fears aren’t subsiding in the new normal. People realize that paying for the care they need isn’t always possible within the constraints of their family's budget.

While health systems and frontline workers are doing as much as they can with available resources, we can offer greater provider fulfillment as well. Many organizations are navigating the impact of the pandemic, including cuts to their budget and staffing, and trying to resolve revenue challenges without taking on the added risk or expense of collection processing. The higher the bill, the longer it can take a patient to make a full payment. Approximately 81% of providers surveyed say they struggle to receive payments within 30 days when a patient owes $1,000 or more.

The Opportunity for Solutions

Patients should be able to access the care they need, just as health systems should be able to focus time and resources on delivering quality care, not on administrative support, like billing. Revenue cycle management in health systems previously focused on collecting reimbursement from insurance carriers versus the patient. Now, as systems and resources are more stretched financially, managing dual collections is incredibly challenging. Organizations may be writing off patient accounts receivables because they require a different process and staff than insurance reimbursements. A more consumer-centric process is needed to solve both sides of the issue.

Against this backdrop, hospital systems have created new revenue streams throughout the pandemic via telemedicine and remote patient monitoring (RPM) of patient populations at home, ultimately expanding access to care. Analysts recently forecast sevenfold growth in telehealth by 2025 – a five-year compound annual growth rate of 38.2%.

Today, healthcare decision-makers have an opportunity to integrate new payment solutions to take on both sides of care access and workflow—ones that work with health systems to improve the entire patient experience by helping them pay for the care they need in ways that help the individual. Hospitals are also recognizing the need for payment flexibility, giving patients payment options for medical expenses not covered by insurance to provide them with the best path to treatment.

Flexible and Convenient Payment Options—a Powerful Path Forward

Patients today want more out of their care, specifically payment flexibility to help manage their personal and financial health. This consumerization of healthcare is driving healthcare providers to offer patients more payment options, such as credit and debit cards. The pandemic has also propelled healthcare consumerism forward, accelerating the digital curve and increasing the demand for more convenient and transparent interactions. Younger healthcare consumers, in particular, are interested in digital payment methods and third-party payment solutions.

While these improvements may feel like a tall order, they spell out a unique opportunity to engage patients more proactively in their health and finances. Addressing patient demand for flexible and convenient payment options is also a powerful way for health systems to build loyalty, sustain their business and improve their revenue cycle. The following are key points along the patient journey where these options can be a differentiator for practices:

  • As a relationship-building tool: Helping patients understand payment options and secure credit before care is needed, so they can easily manage the best path forward for healthcare payments.
  • To improve point-of-service: Options that help navigate the point of service, taking the uncertainty out of care decisions for patients and providers.
  • When bills are received: Transparent payment options offered as a routine part of billing to eliminate unexpected costs and take the pressure out of stressful situations.

Integration is also becoming more important than ever, and health systems must explore ways to leverage technology to expand customer services and meet patients' new and evolving needs. CareCredit, for example, recently launched the CareCredit Patient Financing app within the Epic App Orchard, building on its 30+ year history as a financing option for treatments and procedures that typically are not covered by insurance or for times when insurance doesn't cover the full amount. By making it easier for providers who accept the CareCredit credit card to offer patients a convenient payment option within the Epic MyChart portal, patients can have more seamless interactions while healthcare providers can focus on administering life-saving care.

Embrace Trends Now to Stay Ahead of the Curve

While trends like the rise of consumerism and increased patient financial responsibility were emerging before the onset of the pandemic reinforced the need for payment options to allow more people to get the care they need without the health system assuming the payment risk or collection expense. This is especially important as physicians and practices are increasingly concerned about operating in today’s environment following a prolonged period where their primary sources of revenue—which fund staffing and other resources—went dry. Reconciling payments faster and reducing administrative time on billing is now more valuable than ever.

Not only do patients want physicians to be more aware and engaged in payment solution offerings, but many are also looking for individualized experiences that mirror what they've become accustomed to in online retail experiences. A recent survey by CareCredit and the management consulting firm CWH Advisors found patients are seeking the same level of convenience as in other facets of life, where they can select flexible payment options for online purchases or use mobile payment services for secure person-to-person transactions. More than half (51%) of survey respondents said they use financial and healthcare apps multiple times per week, while 75% of younger patients reported using new person-to-person or digital payments to pay healthcare bills.

As more customers seek greater satisfaction and engagement in their experiences with health systems, having more upfront financial conversations with them ahead of treatments, such as family planning or elective surgery, is a critical way to help them feel valued. Providers can also speak with families about how unplanned expenses like emergency department visits can arise and how patients can secure payment options in advance to ensure they have a way to pay. Investing the time and resources now is the best way to stay ahead of the curve and improve the patient journey in this rapidly evolving landscape.

Author Information

Shannon Burke is senior vice president, general manager of Health Systems at CareCredit.