$140 billion in unpaid bills — and counting.
We’re paying higher prices and paying out of pocket more often for healthcare, from the most basic services to elective procedures. The sticker shock from statements that bluntly lay out the stark warning that “you may owe your provider” hundreds or thousands of dollars can have a negative impact on the continuum of care.
Alberto (Beto) Casellas, executive vice president and CEO of Synchrony Health and Wellness, told Karen Webster that healthcare financing and flexible payment options can help ensure that patients get access to the care they need in a timely and affordable fashion.
The conversation came against a backdrop where 36% of patients in a recent survey noted that a difficult-to-track or hard-to-understand billing process is an important reason they would switch healthcare providers.
A patient’s relationship with the healthcare provider and the billing process are inextricably linked. The data shows that patient and financial needs impact the overall healthcare experience and are a main consideration when making choices.
Out-of-pocket expenses are on the rise as third-party payors are paying less and less. Industry-wide estimates of $140 billion in unpaid expenses point to the fact that there’s an inability to plan ahead and to anticipate what the financial responsibility will be.
The surprises — unpleasant surprises that come with what we might term healthcare sticker shock — are due largely to a lack of transparency, and indeed an authenticity, around the payments experience.
Most people are aware that there’s a copay due when visiting a provider — but beyond that sure-fire obligation, health care payments and obligations are a black box. The result can have negative implications for an individual’s health (and for providers’ revenue streams).
As Casellas said, “Patients today are relying on that financial transparency to say ‘yes’ to a particular procedure.”
Shifting to Payments Choice
That $140 billion in outstanding payments is spurring companies to shift the way they think about payments’ place in the natural flow of healthcare — the bill is no longer simply presented as a paper or e-mailed statement weeks after the tooth is pulled or the surgery is done.
Casellas said ideally, would-be patients should be informed early in the treatment protocol — not too long after diagnosis and recommendation from the healthcare provider — how much a procedure is going to cost, how each component is billed and calculated, and ultimately, what will be due out of pocket.
To get to that level of transparency, Casellas said healthcare providers are partnering with third-party providers (Synchrony’s CareCredit included) to offer flexibility and a range of payment options to patients at the point of treatment so that they can make informed and budgeted decisions about care and its affordability.
There’s some level of education needed, Casellas noted, so the company has a team of employees in place that train providers to introduce these financial topics up front to patients, detailing what a monthly payment looks like, for example.
We’re headed, then, towards an environment within healthcare where consumerism is taking hold — and patients, as a result, are seeing better levels of service. Streamlining payments would help fill in the gaps as individuals, especially in the age of the pandemic, have learned to log in to portals and get links and schedule appointments on devices.
Providers, Casellas said, are also aware that patients bear at least some responsibility for payment, and that offering several options (including credit or installment payments) can mean the difference between getting the procedure done or postponing it indefinitely.
The providers also benefit from shorter cash flow cycles, as measured from the time patients book appointments and sign on for procedures to the time that payments wind up in practitioners’ coffers. Having payments stretched out over several months works well, too, as those payments are akin to steady and predictable cash flow — sometimes in just a matter of days (not months).
These models remove the burdens of in-house financing and free up staff to work on other administrative tasks, rather than trying to collect from a slew of insurance companies. As for changes in payments timing, as many as nine out of 10 patients would like the option to pay before their visit.
In some cases, Casellas said, the patients relish the ability to pre-pay a bit of their healthcare costs when the appointment is booked (the waiting room is thus extended to the mobile device or even the parking lot before the patient walks in). Providers are beginning to embrace that flexibility, he said, where just a few years ago that would never have been the case.
As Casellas told Webster, “Bringing that conversation up front, having the comfort to be able to talk about the financial piece of the equation, the financial piece of care, is important. A good patient experience is ultimately going to become a good provider experience.”