How self-pay can be turned into a provider advantage

Frank MassiRevenue Management

Consumer? Consumerism? Consumerization? In the context of healthcare, all three evoke different perspectives (and emotions) regarding the healthcare continuum and the end-to-end patient experience.

From a revenue cycle perspective, for what is known as the “patient financial experience,” the word we use is consumerization. This implies action, and lots of it; an ongoing effort universally acknowledged and urgently needed to close the considerable gap with e-commerce norms.

Patients are likely to remember the billing experience as their last interaction of an episode of care and extrapolate that memory to the entire encounter (often negative). Revenue cycle’s role – and by extension Salud’s – is therefore huge. Salud’s charge is to satisfy the consumer, live up to the expectations of consumerism, and aggressively undertake with our provider partners the magnitude of the ongoing systems- and process-build for the digital patient engagement experience. Taken together, this is process of consumerization.

The urgency can be measured by declining patient satisfaction scores, eroding net promoter scores, the exploding volume of patient balances, a spike in “uncollectibles” (bad debt), and an unsettling rise in patients avoiding care altogether due to the expense.

Where to start? As a revenue cycle services outsourcing company with a culture of doing what’s best for the patient, Salud is committed to helping shape this future with innovative, intelligent solutions, beginning with arguably the most remunerative process, self-pay account follow-up.
A technology-enabled and blended revenue cycle services approach, constructed and implemented properly, consumerization can pay not just for itself, but also fund enterprise-wide patient loyalty and patient engagement initiatives, in part or in whole.

The quickest and least expensive access to new operating capital was and still is in a provider’s own revenue cycle. This means that “self-funding patient loyalty” is achievable, and thus rev cycle’s and Salud’s potentially huge contribution, not only to financial health, but to the overall health of the community.

The process of consumerization
Salud has amassed the expertise and vision critical to what it takes to operate a revenue cycle in the digital age, where “rev cycle meets consumerism.” With mobile. With AI. With psychology-based machine learning. With a relentless pursuit of “narrowing work” and therefore narrowing labor expense to only that which is “meaningful.” Meaningful work enables highly engaged employees. Highly engaged employees enable highly engaged patient consumers.

Salud has organized its innovations around the patient as payer in three major ways: Connective. Predictive. Prescriptive.

  • Connective. How and when revenue cycle digitally “connects” to patients and in what balance versus live contact, interactive live chat and interactive automated chat (natural language processing).
  • Predictive. How revenue cycle proactively and in real-time captures intelligence to, for example, predict denials, to predict best use of “psychology of commitment” analytics.
  • Prescriptive. How revenue cycle can “prescribe” payment plan options custom-fit to actual checking account “behavioral analytics” (versus less reliable FICO scores). Also, “prescribing” contact call windows fed by “authoritatively accurate” data on caller device ownership and precise times of device use.

Affordability chokes off access
Access to healthcare has long been a hot topic, but from the standpoint of helping patients obtain physical access or admission to a health facility. Today, affordability is the true barrier to access due to increasingly higher-cost health plans and exploding out-of-pocket costs.

It’s a harsh fact that 64% of patients avoid care due to high costs. Some of our neighbors, coworkers, and family members are urgently in need of care but can’t afford it. In far too many scenarios people are dying due to their medical expense burden. Healthcare bankruptcy filings more than tripled in 2017 and now represent the No. 1 reason for bankruptcy filings.Reading deeper however, it’s the “access to affordability” that is the issue for a vast majority.

Progressive revenue cycle professionals are aware of the multitude of tools and services to interact with the patient consumer to determine a level and method that is “affordable.” But without a trusted partner, it’s an arduous task for a provider alone to evaluate, integrate, and operate all the tech and services elements into a single workflow.

Salud’s perspective is that revenue cycle management in the digital age can be the “bridge to affordability. Interacting on the patient’s terms, applying advanced psychology-based processes to prompt payment, and deploying algorithms to predict and literally “prescribe” financial clearance tasks and call windows that generate increased promises-to-pay and enormous leaps in right party contact.

Answering the call to action
Revenue cycle operators are literally on the front lines as we face patients at their most vulnerable, from patient access to patient account resolution. Revenue cycle operators are also among the most technically astute and the most empathetic, making them the best people to address the task of consumerization.

Salud is excited to be working with our partner clients to facilitate this journey.