Healthcare should embrace consumer-centered, proactive revenue cycle management
Editor's note: This is part two of a four-part series that will be published throughout the week.
Consumerism is no longer a buzzword – it's a part of our healthcare ecosystem. Patients are empowered to choose providers who have excellent bedside manners at health systems that provide convenient, timely and accessible care. Amidst an evolving and demanding healthcare landscape, organizations are investing in health IT solutions to streamline workflows, save time and improve costs with the ultimate goal to deliver better care. As our industry continues to shift, we must evaluate the care delivery process from the front-end to back-end to identify opportunities for improvement with the consumer in mind.
Revenue cycle management must also embrace a consumer focus. The consumer experience begins and ends with the revenue cycle management process, from the time an appointment is scheduled, to registration, to when a statement is submitted for payment. While quality of care and improved health outcomes remain top of mind, a consumer's first and final impression of the care experience is important and will impact overall satisfaction.
A few states have passed legislation that requires hospitals and providers to make charge data available to patients online or upon request. Charge data reflects the costs for services based on clinical documentation before payer review. However, consumers cannot base their care decisions on charge data alone; it could dissuade them from choosing the best provider for their care and result in less than optimal outcomes.
Organizations should consider taking a step back to evaluate all of their touchpoints with the consumer. A cohesive strategy is necessary to improve transparency and engagement, including when they interact with the revenue cycle management process.
One opportunity to improve the consumer experience is during point-of-care transactions. Many organizations are hesitant to implement POC transactions on-site at the risk of harming consumer satisfaction. On the contrary, many consumers appreciate straightforward transparency and would prefer to understand their financial responsibility upfront, rather than receive a bill months after with unclear line items and a higher-than-expected cost. Simple and consumer-friendly statements that reflect transparent costs and include education about insurance copays and medical benefits can significantly improve overall satisfaction.
Still, consumers face high deductible health plans. High-risk and socioeconomically challenged populations are particularly burdened by their financial responsibilities. An integrated, cohesive revenue cycle management strategy that promotes transparency with consumers will help establish trust, improve engagement and ultimately create loyalty. A sophisticated revenue cycle management process creates simplicity out of complexity.
Today, we are compelled to improve the health of the consumer beyond their immediate care needs. Our industry has made tremendous progress with preventive population health management solutions that help monitor and manage care outside the traditional hospital setting. An enterprise-wide revenue cycle management process plays an integral role in this mission as well. Consumers who are facing complex, chronic or life-threatening illnesses often experience significant financial burden and, in some cases, cannot afford the care they deserve. Fortunately, we can help mitigate their burden with clear information and education to guide them through the revenue cycle management process.
Consumerism is not a passing industry trend. It's an opportunity to serve your community in a way that exceeds expectations, increases knowledge and improves engagement. Helping individuals understand the financial side of healthcare will better enable them to fulfill their financial responsibilities and bring us closer to more proactive management of our populations.
HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.
This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.