Leverage Your HIS Investment With the Right Payments Infrastructure

Are you getting the most out of your HIS investment? Most we talk to aren’t, specifically when it comes to patient payments.

It’s understandable, really. HIS systems were designed originally to marry the clinical and business data of hospitals, not necessarily to increase patient engagement or help get more payments in the door. With the HITECH act in 2010 and ICD-10 documentation in effect, documenting and creating charges is mostly straightforward. The nuances of collecting the revenue on those charges is what keeps CFOs up at night, the source of which is rapidly shifting from the payer to the patient.

According to this analysis, the average provider’s patient accounts receivable for insured patients is increasing while collections remain flat. Patient A/R has increased consistently since insured patients began switching to high deductible health plans (HDHPs) in the mid-2000s. Now, providers are facing incoming policy changes that could cost up to $1.7 trillion dollars in uncompensated care costs over the next decade. (more…)

HIMSS RCITF Unveils the Patient Financial Experience of the Future: A Continuing Journey

The 2017 HIMSS Revenue Cycle Improvement Task Force (RCITF), of which Patientco is a member, has launched a microsite offering a virtual walkthrough of a consumer-friendly patient revenue cycle experience from start to finish. The site is built upon the ideas laid out by last year’s RCITF and turns the proposed framework into a chain of actionable technology-enabled steps.

The task force collaborated throughout the year on a theoretical patient’s journey through an episode of care to demonstrate how health IT of the future will support decision making for the patient, her husband, and their medical team as it relates to their financial experience.

The microsite is an interactive walkthrough starring a woman who falls in her kitchen, injuring her knee. Leveraging the technologies that will be featured at the HIMSS17 Interoperability Showcase, she and her healthcare providers are able to treat the injury in a way that is both clinically and cost effective. (more…)

Looking to Improve Your Patient Financial Experience at HIMSS17? Don’t Miss the Interoperability Showcase!

The HIMSS Revenue Cycle Improvement Task Force (RCITF) will showcase a patient’s full financial journey through a particular episode of care at the HIMSS17 Interoperability Showcase.  Attendees will have the opportunity to interact with market-leading revenue cycle technologies every step of the way and see how these technologies can work together to create a better patient financial experience. Patientco will be showcasing our enterprise payment platform alongside other members of the Task Force to help you design a patient revenue cycle solution that works together to best fit your needs and those of the patients you serve.

The technologies featured in this year’s RCITF showcase include:

  • Search tools that take into account a patient’s health plan, deductible, location, and other factors to steer patients to in-network providers and avoid costly mistakes and network inefficiency.
  • Price transparency and estimation tools that can deliver a customized quote to the patient at the time of registration.
  • Eligibility and verification tools that take into account a patient’s past EHR records and two-factor authentication
  • Healthcare-specific point-of-service payment tools to accept multiple payment methods at the time of care and securely store payment information to streamline future transactions.
  • Tools that allow the patient and provider to determine follow-up care that takes into account the patient’s insurance status.
  • The latest advances in patient-friendly billing including self-service payment plans and online payment tools that allow clear communication between patient and provider.


New Report Suggests Increased Patient Financial Responsibility Impacts Provider Net Revenue

By Patrick Creagh, Marketing Specialistshutterstock_88642495

In past blog posts we looked trends in patient financial responsibility for patients covered under employee-sponsored insurance plans. One post examined increasing out-of-pocket costs and the other looked at increasing premiums and deductibles for patients covered under employer-sponsored insurance plans. While the trends of the cited Kaiser Family Foundation survey imply that overall patient financial responsibility is increasing, we could only speculate on these trends effects on provider financial health.

Now, a new benchmarking study from Crowe Horwath claims that increasing patient responsibility after insurance negatively affects provider net revenue. In other words, when the payer mix shifts towards the patient, provider revenue suffers. The creators of the report used a metric called Self Pay After Insurance (SPAI) to indicate the amount a patient owes after commercial insurance settles a claim. This is the same as out-of-pocket-costs except that it only measures for patients who are covered by commercial payers.

With 835 remittance data from 199 healthcare facilities, the study benchmarked the SPAI numbers against facility collection rates. They found that higher patient responsibility as a percent of the total charge resulted in lower net revenue for providers from Q3 2015- Q3 2016. This suggests providers have more success collecting from commercial payers than patients. This is significant because employer-sponsored coverage is moving towards models that result in even higher out-of-pocket costs for patients. (more…)

Post-election Outlook for Healthcare IT and Patient Payments

By Patrick Creagh, Marketing Specialistshutterstock_87321571

The results of Tuesday’s election were improbable, according to most forecasters and pundits. Aetna CEO Mark Bertolini claimed Wednesday that his team didn’t forecast the impact of a Donald Trump victory because it seemed so unlikely. Perhaps more consequential to healthcare than the Presidency alone is that the Republican party now also controls the house of representatives and the senate.

What does this mean for the multi-trillion dollar US healthcare industry? Beyond promising unspecified change to the current Affordable Care Act, healthcare was hardly discussed on the campaign trail and both candidates offered little specifics on their plans.. President-elect Trump announced that healthcare will be the first priority of his administration and reportedly named Andrew Bremberg to lead the healthcare transition team, along with Paula Stennard to help develop healthcare policy. Both Bremberg and Stennard are relatively established policy consultants who have worked for Republican politicians in the past.

Despite the mantra, “Repeal and Replace [the Affordable Care Act]” on the campaign trail, the President-elect has expressed desire for some parts of the law to remain intact: specifically, the ban on discriminating against patients with pre-existing conditions and allowing children to remain on their parents’ policies until age 26. Realistically, it will be up to both parties in Congress to discuss and compromise on specific tenets of any reform policy, as Republicans lack a ‘Supermajority’ to bypass Democrats on the floor. (more…)

What Do Increasing Premiums Mean For Patient Payments?

by Patrick Creagh, Marketing Specialist

In September we looked at high deductibles and their impact on patient payments. Healthcare providers look at trends in deductibles because that is where the majority of patient A/R originates. Premiums, on the other hand, are paid to insurance companies and do not directly impact patient A/R. However, premiums do affect the patient’s propensity to pay, and this can have downstream effects on satisfaction with the billing process, even if the provider is not responsible. For this reason, it’s worth looking at premium trends.

A Commonwealth Fund study was released last week that examined employer-sponsored coverage trends from 2006-2015. In the chart below [exhibit 5], you can see that premiums and deductibles increased as a percent of median household income in 2015 at roughly 10%. So an employee making the median household income will, on average, spend 10% of his or her income on health insurance. It’s important to remember that half of Americans will spend more than 10% given that they earn less than the median. (more…)

Patientco and the HIMSS Revenue Cycle Improvement Task Force: An Update

shutterstock_114034636The HIMSS Revenue Cycle Improvement Task Force (RCITF) is an initiative that brings together a group payer, provider, and vendor executives to brainstorm and lay a framework for a modernized healthcare revenue cycle. The roadmap and solutions are designed to be vendor agnostic and focus primarily on the patient financial experience.  

“This year, the Task Force is focusing on finding solutions that keep the patient’s perspective top of mind while redefining where revenue cycle management should be in the future in order to support this,” said Bird Blitch, CEO of Patientco and chairman of RCITF. “At the end of the day, every individual is a consumer of healthcare, so we start and finish with that viewpoint in mind.” (more…)

Plug-in Payments: Why Practices Should Integrate Their Hardware, Software, and Processing Agreement Onto a Single Technology Platform

Many healthcare providers are still using outdated or inefficient systems to process patient payments. Until recently, smaller practices typically only handled small copayments and rarely, if ever, needed to manage large transactions as insurance was their primary revenue source.. Unfortunately, this is no longer the case. The Affordable Care Act minted millions of newly-insured patients, most of which have high-deductible plans, increasing patient volume and patient A/R at many practices.

Exhibit 7.34: Among Covered Workers with Copayments for a Primary Care Physician Office Visit, Distribution of Copayments, 2006-2016

With increased copays and higher deductibles than ever, patients are more conscious about their medical expenses. Prior to meeting a deductible, a routine physician visit may cost hundreds of dollars, money the patient may not immediately have on hand at the time of the visit. While the proliferation of financing options and payment plans is a positive development for patients, it can create additional work for the business office staff if not implemented with ease and efficiency in mind, particularly at scale. (more…)

Out-of-Pocket Healthcare Costs Increase in 2016

By Patrick Creagh

The Kaiser Family Foundation released the results of their 18th annual employer health benefits survey and the average deductible (for single workers) has increased to $1,478, compared to $735 in 2008. On the bright side, the survey showed just under ten percent of Americans were not covered by health insurance and average premiums only increased by 3%.


What does another year of increases in out-of-pocket costs mean for healthcare providers and their patients? It means both parties will have more ‘skin in the game’, leaving a larger segment of the healthcare revenue cycle to be settled between the provider and the patient.

According to the survey, 40% of patients insured by their employer are covered under a high deductible health plan, with or without an HSA (healthcare savings account). These patients will be more likely to seek out payment plans or financing for any episode of care that approaches exceeds their deductible.

Providers are already taking steps to address the shift to consumerism in healthcare. In Patientco’s State of the Industry Survey report, 86% of providers rated patient satisfaction as a top concern regarding financial experience. Providers are also transitioning to EMV-compliant credit card processing if they have not already, due to the passed deadline to make the transition.

If these trends continue as expected, providers will need to prepare their business office staff to manage increased volume of patient payment transactions, and the respective task of reconciling and posting these payments.

You can download Patientco’s State of the Industry Report for free, click here to get your copy.


3 Findings From Patientco’s State of the Industry Survey

This week, Patientco released the results of a survey we issued to healthcare providers last month. The questions focused on payment methods offered to patients by providers as well as areas of focus regarding payments for the coming year. You can view the full survey report here.

Here are 3 interesting findings from the report:

Patient satisfaction is a top concern for 86% of healthcare providers.

Along with collecting payments upfront (84%), patient satisfaction was the top concern for healthcare providers regarding patient financial experience. As technology tools and social media increase transparency and consumerism, providers are taking steps to improve the non-clinical aspects of patient experience. (more…)