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Health Orgs Still Struggle with Patient Billing


Increased transparency and consumer-friendliness are common goals in improving billing, but more work is needed.

Opening envelope with warning letter

A large part of the consumerization push in healthcare has centered around billing. This is often a patient’s most frustrating and confusing contact with healthcare-making it prime real estate in the fight for transparency.

Most large healthcare organizations have been tackling the issue in recent years, and while improvements have been made, much more work is needed.

That’s according to

a survey

of 23 executives from 20 of the top 100 U.S. health systems (based on net patient revenue), conducted by commissioned by patient payment and engagement platform Cedar and conducted by The Health Management Academy. Overall, the study found that while many organizations are prioritizing patient experience with finances, many still struggle to simplify patient billing and align it with revenue cycle management (RCM).

More than half of the executives surveyed from those organizations said that identifying “consumer-centric financial experiences” as a top 10% priority. And while the survey found that most organizations have at least some plans to achieve that priority, most plans are implemented in a fragmented way-just 63% said they were aligning at least four of eight points (such as scheduling, account creation, billing, or final payment) across the patient financial journey.

So what’s standing in the way of progress? Many executives said that, while external forces like increased regulations or consumer expectations are difficult to deal with, the primary barriers to improving their patients’ financial experience are internal.

For example, 75% of finance executives said competing priorities are the biggest barrier, while consumer executives said patient engagement is their biggest barrier. This could indicate a disconnect in the C-suite that needs to be bridged.

Related: Survey Sheds Light On Frequency Of Surprise Medical Bills In America

Executives also identified other problems, such as a lack of consumer-friendly resources, struggles to consolidate bills, inconsistent RCM technology use, and limited tracking of patient-centric metrics when measuring the success of billing and RCM.

The survey identified several areas that health executives should focus on:

  • Price transparency. Just 65% of health systems have OOP calculators that can help patients estimate the cost of their care and plan for it. And while 80% have chargemasters posted, those are often difficult for patients to navigate and can lead to incorrect estimates.

  • Consolidate bills. Most health systems are using alternative billing methods, such as a patient portal or online billing applications. However, 35% don’t offer a consolidated bill, and those that do often only include charges from within the health system. That means that many patients see multiple bills from multiple organizations-in different formats, for different amounts, potentially creating confusion.

  • Increase flexibility in payment plans. While most top health systems (82%) offer flexible payment plans with low to no interest, more can be done. Just 41% offer self-select payment plans, which could give patients even more control of their options.

  • Adopt tracking metrics. While all health systems track traditional RCM elements related to financial well-being (e.g., net collection ratios, claims denial rates), more work is needed in tracking patient-centric metrics. Just 67% of organizations track patient satisfaction, 58% time to bill, and 25% bill readability.

  • Implement end-to-end RCM tech. Forty-one percent of those surveyed use an end-to-end RCM solution, with 0% using RCM tech for one or more RCM components and 8% not using one at all.
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