The Centers for Medicare and Medicaid Services (CMS) projects that, by 2024, nearly $1 of every $5 spent in the U.S. will go toward healthcare. The majority of that spending will be direct from patients to providers, with the typical family of four covered by an employer-sponsored health plan experiencing an increase of $12,000 in out of pocket expenses.
With patients assuming greater financial responsibility for their care, hospitals, physician groups, and other provider organizations that underestimate their influence on the revenue cycle are placing their financial stability at risk. In today’s environment, providers must be concerned not only with whether or not a patient has insurance, but also what kind of insurance and how it impacts who pays for what and how much. They must also understand how to walk the fine line between care partner and bill collector.
Striking that balance to effectively manage the revenue cycle in today’s patient-centric payment landscape requires engaging patients in the payment process even before the first encounter. That begins with a patient-friendly financial communication strategy based on proven best practices to ensure consistency, clarity and transparency. HFMA has developed a set of common-sense best practices to do just that, outlining steps “to help patients understand the cost of services they receive, their insurance coverage, and their individual responsibility.”
Adds HFMA, “adopting these best practices is a worthy goal for all healthcare organizations.”
The best practices applicable to all patient financial communications include:
- Ensure that compassion, patient advocacy and education are part of all patient discussions.
- Use standard language to guide staff on the most common types of patient financial discussions.
- Where appropriate, utilize face-to-face discussions to facilitate one-time resolution.
- Communicate availability of supportive financial assistance and make financially supportive policies available to the community.
- Be proactive about communicating with the patient.
Staff education and training is an important best practice for effective financial communications. According to HFMA, everyone who engages in patient financial discussions should be trained annually on the best practices themselves, but also financial assistance policies, common coverage solutions for the under- and uninsured and customer service. Organizations should also ensure broad awareness of financial communication best practices across the enterprise, as well as ensure the patient perspective is represented when developing standard language used in patient financial discussions.
Other HFMA patient financial communications best practices include:
- Ensure communications are understandable by patients
- Include verification of patient information and the patients’ preferred methods for future communication.
- Respect patient privacy during all financial discussions.
HFMA also recommends regular patient surveys assess performance against the best practices. The full set of best practices can be found here.
Patient-centric financial communications are vital to financial fitness in today’s reimbursement landscape, but they will only be effective if they are teamed with technologies that provide current and actionable information on patient responsibilities. These technologies, which must provide an easy way to facilitate the patient’s preferred payment method, will be the topic of Part 2 of our three-part series on patient financial engagement.