Healthcare Providers, Insurers Test New Era of Pricing and Payments to Retain Patients

With a third of U.S. consumers saying they’ve waived necessary medical tests or treatments over cost fears that originate with opacity and get denser from there, change is dangerously overdue.

Depending on whom you ask, health systems have been extending payment options for years — if not by design, then by default — but even some who agree think it’s faulty reasoning at best.

“Health systems will tell you they’ve been financing patients for a long time,” CareCredit Senior Vice President and General Manager of Health Systems Shannon Burke told PYMNTS. “What we haven’t been good at is letting patients know about financing and giving them broader options, like they see in other parts of their lives.”

Burke joked, “You don’t just throw a bunch of groceries in a cart and have no idea [of the costs] until you get to the register. You want to know what costs are. You want options to pay those costs if you don’t have the means to do it immediately.”

“Wellness And Affordability: How Payments Practices Create Positive Patient Experiences,” a PYMNTS report with research sponsored by CareCredit, found that 33% of consumers have opted out of medical interventions. Twenty-one percent of them cited cost as the most important reason why, and not being able to afford the treatment was the most important reason for 22% of those who say they have opted out of needed medical treatment.

Get the study: Wellness and Affordability: How Payments Practices Create Positive Patient Experiences

Meet the Patient as Consumer

Slowly but surely, medical costs have shifted off of employers and health plans to instead rest on consumers’ shoulders, which isn’t working that well for anyone — starting with the patient.

Burke said that at one time, “We just consumed care. We evolved over time into payers because of the nature of how healthcare was financed and paid for. The latest thing that is coming to light is that we have become customers.”

Embedding payment options along the healthcare journey, from scheduling through post-care, is how forward-thinking operators are dealing with fundamental changes in health payments.

“The new wrinkle is the health systems acknowledging that one size is not going to fit all,” she said. “You and I probably have different expectations when we receive a bill. That’s really what it is, meeting the demand and flexibility and choice of the customer.”

Burke said the knowledge of having an available line of healthcare credit is not only comforting and valuable for patients, but it gets doctors paid and keeps credit scores healthy.

“Costs go up when we delay care. Things don’t tend to resolve themselves in most cases,” she said. “What we’re doing as part of financing is making sure we enable patients with a means and the comfort and confidence [of] knowing what the costs are.”

See also: New Financing Options Help Patients, Practices Manage Rising Healthcare Costs

A Triumph for Transparency

The post-pandemic patient has morphed into a paying customer, and as such, needs to get comfortable asking their doctor pricing questions normally reserved for a retail transaction. This isn’t how we’ve been trained to interact with healthcare, but we’ve secretly wanted to.

As The Wellness and Affordability study found, the difficulty involved in obtaining costs before a visit or treatment is an important reason that 38% of respondents would switch healthcare providers. Additionally, 36% said they would switch providers based on their practitioner’s billing process being difficult to track or understand.

“There was a time we had one doctor — we started with that doctor probably with our family, that was the only doctor we knew and that’s the doctor we went to, and we never thought any differently,” Burke said. “The study certainly shows that when we don’t get the experience we want and when we don’t get the customer service we want, we will walk.”

Health systems and practices can head the off the incessant search for a second opinion at the pass by emphasizing price transparency and including payment options in their conversations about care.

“Many unfortunate things came from COVID, but certainly one of the byproducts of it, at least in healthcare, is the fact that I think it’s really brought more transparency [and] the need for financing to the forefront,” she said. “I believe we’ll continue to see this trend.”

The new mindset starts with the patient as consumer, and all stakeholders need to grasp it.

As Burke said, “Just like we think about patient-centric and patient-driven clinical care, we need to think about patient-centric payments. It’s not in the back office anymore. It’s more and more pulled out because we, as the patient, are paying more of that care and therefore want that transparency — and, frankly, do not want to be surprised.”

Read more: 89% of Consumers Say Healthcare Estimates Make Them Feel Better, Paired With Financing