by Patrick Creagh, Marketing Specialist shutterstock_128018483

Over the past couple years, healthcare providers have witnessed a shift in the payer mix from the insurance providers to patients. This enrollment season, we can expect that trend to continue and both the number of high deductible health plans as well as the deductibles themselves will increase. That second part is particularly important because, with many patients signing up for plans with individual deductibles upwards of $6,000, providers are likely to face difficulties with patient financial responsibility when a single trip to the ER could potentially result in thousands of dollars of out of pocket responsibility.

So far, providers have begun upgrading confusing statements, adding online bill pay, and offering more patient financing options in order to dampen the effects of these HDHPs on their patient revenue. These steps should be applauded as they also boost patient satisfaction in an area where patients are typically not satisfied with their experience.

That said, the insurance coverage forecasts indicate that providers will have to go much farther in their efforts to remain financially solvent in 2016. Healthcare Finance News reports that healthcare finance executives are calling 2016 the year of the integrated revenue cycle, alluding to the integration of revenue cycle technology across the different aspects of billing as well as across the multiple entities that comprise an episode of care.

Having passed the ICD-10 deadline, providers have hopefully completed their technology investments in the coding/claims part of the revenue cycle. Now financial leaders are turning their attention to their patient revenue streams and evaluating opportunities to improve efficiency and performance. The following are 3 things we expect providers to focus on in 2016:

Cultural Changes at the Point of Service

One area that providers are starting to address is the opportunity for revenue at patient access. With improving estimation/eligibility technology, providers are often able to calculate a patient’s financial responsibility at the time of service, especially for straightforward episodes of care such as a doctor’s appointment or a blood test. However, requesting payment at the time of service may be a cultural change for your staff and patients alike. As you invest in changes to your patient access process, make sure they are accompanied by clear, empathetic communication and stress importance on helping patients understand their financial responsibility as well as any aid/financing options.

The Added Importance of Choosing the Right Payment Processor 

When patient revenue processed at the point of service was low, the payment processing tools and contracts were not as critical as they are today. Now, in addition to being responsible for accepting more payments at the point of service, providers must be savvy in choosing a processing partner that fits the unique needs of healthcare and does not sabotage your revenue with hidden fees and charges. An efficient credit card processing solution should have EMV-compliant terminals that integrate with your payments platform and automatically consolidate and deposit payments on a daily basis.

Payments visibility at every location

Many large health systems and practice groups find it challenging to manage different streams of revenue across several to dozens of locations. If each location has 4 separate streams of patient revenue and a system has 12 locations, that’s 48 separate streams of revenue that must be managed. The best way to accurately manage these individual streams is on an integrated revenue cycle platform- one that allows you to drill down into each stream at each location in a handful of clicks. A consolidated revenue cycle technology stack has the added benefit of integrating additional locations or entities with ease.

If 2015 was the year of switching to ICD-10, we expect 2016 to be the year that providers integrate their patient revenue cycle, starting with patient access and finishing with visibility across every payment stream.


To learn how Patientco Essentials can help improve your payment experience in 2016, click here.