The growing chorus of patients with high deductible plans places a greater burden on medical providers to implement patient revenue cycle solutions that optimize net collection rates. Patients are now the largest payers in healthcare. Patient payment technology solutions have the unique ability to promote healthcare price transparency by educating and empowering healthcare consumerism with insurance eligibility information, cost-of-care estimates, co-pay and deductible amounts, and estimates of what balance may be owed post insurance claim adjudication. Learn more about how and why implementing a patient payment collection technology solution empowers, engages, educates, and delights patients through a convenient and intuitive patient check-in kiosk. Plus, learn more about the new “vitals” to track patient revenue cycle management to improve patient net collection rates in this webinar slide deck.
14. Lebron James’ $13.4M Miami
Mansion
Or the amount of bad debt written off
for a 100 doctor group in 3-4 years
15. The Rise of High Deductible Health Plans
*Source: NationalCenter for Health Statistics
16. Patient is now the LARGEST payer
High-deductible health plans (HDHPs) are becoming the coverage of
choice for healthcare consumers struggling to pay medical bills in full.
The net effect is that revenues are declining at medical providers.
*Source: Consumer Reports
17. *Source: MedicalGroup Management Association (MGMA)
Bad Debt is Becoming a Problem
$18,337
$29,393
$20,217
$12,679
$20,321
$35,069
$22,833
$14,617
$10,231
$21,045
$15,886
$5,926
$0 $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000
Multispecialty, All Owners
Surgical Single Specliaties
Medicine single specialties excluding general internal medicine
Primary care single specialties
Bad Debt Due to FFSActivity per FTE Physician
Better Performers Others All
18.
19. • Nine in 10 consumers want to know their
payment responsibility upfront.
• Almost two-thirds of consumers expressed
interest in using mobile payment systems, like
Apple Pay, for healthcare bills.
• More than 75 percent of consumers choose to
pay their household bills through online
payment channels.
Consider This:
20. It’s time to stop spraying and praying!
Instead of blasting patients with statements and
phone calls, we need to apply a modern approach.
23. ✔ Transparency encourages patient accountability for
payment.
✔ Empower patients by helping them understand their
coverage:
• What do my benefits cover?
• What am I paying out of pocket?
• What does this bill mean?
✔ Provide patients with cost estimations at the point-of-
service (POS) to shift responsibility.
Empower through transparency
26. ✔ Convenient payment options, like self-service check-in,
enable new ways to engage with patients.
✔ Multiple methods of payment maximize opportunities to
collect, such as: credit cards, ACH, etc.
✔ Leverage smartphone apps and point-of-service
payment
technology.
✔ Benefits include reduction of administrative and
employment
costs, increased patient engagement and satisfaction.
Engage with convenience
28. The power of auto-pay
(adopting a retail
approach)
29. The power of auto-pay (adopting a retail
approach)
• Despite credit card use in daily life, credit card on file programs are not
common practice among healthcare organizations.
• Only 20 percent of providers use a credit card on file for patient
collections as of February 2017!
The Bad:
The Good:
• Storing credit card data on file is a great way for providers to streamline
their revenue cycles and collect more of each patient's financial
responsibility.
• Having a good, clear financial policy and a well-trained staff is key.
• Show patients the benefit: Allows them to pay bills with no need to go
online, write a check, wait for a statement, etc.
31. ✔ Confidence in the way payments are made and collected
allows the patient and doctor to have peace of mind.
✔ Confidence optimizes patient care and builds relationships
with patients.
✔ Confidence enables higher patient retention/satisfaction,
more preventative visits, and quicker and more frequent
appointments.
Delight with confidence
32. The New “Vitals” to Track Patient RCM
Bad Debt Cost to Collect Time to Collect
Overall Health = Patient Collections
33. The New “Vitals” to Track Patient RCM
Patient Net Collection Rate
Patient Collections
Patient Collections A/R > 90 Bad Debt
34. The New “Vitals” to Track Patient RCM
Patient Yield
Patient Collections Cost of Patient
Collections
Patient Collections A/R > 90 Bad Debt
It gets trickier to calculate bad debt outside of hospitals because there are so many different kinds of practices and specialties - compared to only about 5,000 hospitals. There's also a wide variance is the ability of practices to collect (or chase) bad debt.
Using data from 2010, The Medical Group Management Association calculated that ....
Accounts receivable and collections
High-performing groups in this category reported collecting their receivables more quickly than their peers. They had only 7 to 10 percent of their Total accounts receivable (A/R) in the 120+ days category. In contrast, the other groups had 19 to 35 percent of their total A/R in the 120+ day category, indicating that strong cash flow is crucial to the success of any practice. Additionally, 50 percent of better-performers reported collecting 90-100 percent of copayments at the time of service. [2]
The "average" I've heard for years is roughly 15-20% (depending largely on size and type of practice). The more "specialized" the practice, the more easily it is for a practice to pre-filter patients based on ability to pay - and to require payment prior to service. Primary (and pediatric) care can be the toughest because that's also where the highest concentration of "new" patients present.
Annualized - the chart representing actual dollar figures by practice type was also provided by MGMA [2].
Now - assuming the low-end of the average - say 15% - and further assuming that 20% of all healthcare spending is through practices and specialties - the annual amount of bad debt through practices is roughly $66 billion per year.
Relative to healthcare Collection Statistics, the Association of Credit and Collection Professional quoted this percentage.
The national average for bad debt is 3.17 percent [3]
The larger challenge for the practice calculation are those who could well see a payment outside the +120 days in A/R (the number that MGMA did for their study in 2010) and the wide variance in the ability of practices to employ workflows to manage bad debt.
Given that prescription drugs account for about 10% of NHE spending - and further assuming the 3.17% national average for bad debt - that would add another $8-$9 billion annually.
Combined - hospital, pharmacy and practice bad debt - would then be about $120 billion annually - or about 4% of all healthcare spending (NHE).