It’s no secret that healthcare is transitioning from a focus on episodic care to more regular, wellness-driven visits. For hospitals and health systems, this shift into a more value-driven environment has as much impact on the revenue cycle as clinical care. So much that by 2018, 50 percent of Medicare reimbursement is expected to be tied to the value of care.
In this new ecosystem, the key to success will involve transforming processes to enable “value” for both patients and providers.
For patients, much of their value is based on the perception that they receive a quality care experience for a reasonable price. As patients begin to pay more of their healthcare costs out-of-pocket, they will increasingly seek providers who offer the greatest value. Although wellness-driven care is intended to improve overall outcomes, the payment experience also will largely define patients’ satisfaction with their care. After all, the payment process is often the last touch-point they have with their providers, and it’s important to make it a positive one. Unfortunately, most hospitals don’t make this a priority and patient satisfaction suffers.
For providers, value is predicated on having the information and tools necessary to deliver the quality care experience their patients expect, while also receiving payment for the services they provide. A key piece of the puzzle includes having the ability to engage patients in seamless payment processes, making patients happy and enabling a simple, convenient and secure payment experience.
Delivering on both sides of the patient/provider value equation requires hospitals to step into the shoes of their patients and evaluate the entire care experience—including the financial experience—from the patient viewpoint. Patients desire simplicity, and in healthcare, that includes providing clear financial communication and consumer-friendly methods for managing their payments.
Increase financial transparency
Optimizing the patient experience without a complete view of the patient financial picture has long been a challenge for most hospitals and health systems. Moving into value-based care delivery models, patients and providers alike need much more transparency into their financial relationship and obligations across the continuum of care to work collaboratively and efficiently within the patient revenue cycle.
So, how should hospitals optimize their workflows, processes and technology to make the patient payment experience better and more efficient? They can start with these three ways to prioritize the patient revenue stream:
1) Achieve “virtual consolidation” through enterprise connectivity. Lack of interoperability between multiple HIS and financial systems typically leads to information silos. As a result, providers have an incomplete understanding of—and an inability to discuss—a patient’s full financial responsibility for their episode of care. Cloud-based technology can play a major role in providing connectivity and visibility into the patient financial experience across an entire enterprise. Even billing offices and vendors that use disparate IT systems can leverage web-based technology to efficiently share patient information across the continuum of care. Having this comprehensive view will help providers and patients have realistic and beneficial conversations about a patient’s total financial responsibility, thus helping to improve satisfaction.
2) Centralize and automate financial information flow. With the rise of healthcare consumerism, patients want to manage their financial obligations in the manner most convenient for them—just as they do with virtually every other company with which they do business. They want one bill and one payment for all their encounters within a health system. While this is difficult to achieve in a complex healthcare encounter, giving patients consistency throughout their financial experience goes a long way.
Cloud-based technology can help bridge the gaps between systems to centralize patients’ financial experience and deliver more value. With these systems, providers can give patients consistent bills from all parties involved in their episode of care and a single online app where they can log on to view up-to-date account balances, complete transaction history, past bills and receipts, set up payments, or send a message to their provider for clarity.
3) Deliver business intelligence. By gaining a single view of the patient financial profile, hospitals also gain business intelligence that is crucial to personalize the financial aspect of care and fully engage patients. Understanding when, how and ultimately why a patient pays will create a more seamless experience; patients feel more connected to an organization that knows and accommodates their billing preferences. Staff can be more comfortable with patient conversations around financial responsibility if they have a complete picture, which allows them to create a positive touch-point in the payment experience, increasing overall satisfaction. Additionally, deeper business intelligence allows for better decision making, patient revenue cycle optimization, and efficient business office operations.
In the value-based care environment, increased patient satisfaction can mean patient payment optimization for hospitals as well. The fact is, an optimized patient payment experience matters to the hospital bottom line as much as it does to the patient’s pocketbook.
See through patients’ eyes
To be successful in value-based care delivery models, hospitals and health systems must be willing to make bold changes. With patients becoming a major source of revenue, healthcare organizations must fully optimize their processes to provide a high quality patient payment experience. Incremental changes will not be enough to deliver the necessary value for patients and for providers.
Hospitals can take a big step toward enabling value by looking at the revenue cycle from the patient’s point of view. Patients want simplicity, transparency and convenience; one complete view of their financial responsibility for their entire healthcare experience.
Thinking like a patient can enable a faster and more agile shift to value-based care. The challenge for hospitals and health systems is to make the last touch-point with their patients—the financial process—the best touch-point. Can you do that for your patients?