The PFX Voice

Christine Hanson-Ehlinger
Christine Hanson-Ehlinger

It’s not news that patient pay is a growing concern for providers, but we are just starting to see deeper research into the matter as the real-world implications for providers emerge.

The most recent example is new research from athenahealth that examines the patient pay question as well as its causes and gives strategic advice on how providers should approach the challenge. The white paper is geared toward physicians specifically but provides useful insight into addressing general patient payment behavior.

The research results point to the drastic increase in HDHPs as a key cause of the increase in patient pay, with the number of Americans enrolled to this type of plan jumping from on million in 2005 to 17.5 million in 2014 (an increase of 75 percent). That number is expected to increase to 40 million by 2018. For providers, this means multiple issues including patient balances not being paid in full.


Moving Forward

athenahealth’s whitepaper suggests best practices for addressing patient pay challenges. (For hospitals, it serves as a useful framework for building out your self-pay initiatives.) They include a 2-step process including determining current patient pay yield and moving on to identifying tactics that can make a difference.

The whitepaper then builds out four distinct areas of patient pay tactics with finer points of focus under each:

  • Staff Training and Accountability
  • Pre-visit Collections Strategy
    • Pre-visit financial review
    • Patient financial obligation estimates
  • Time-of-service Collections
    • Card-on-file agreements
    • Large-balance payment plans
    • Standardized down payments
    • Collection-focused digital check-in
  • Ongoing Collection Efforts

Hospital leaders will likely get the most use out of the Staff Training and Accountability section as well as the Pre-visit Collections Strategy area which reviews financial obligation estimates and proper pre-service communication. Payment plans, as well as proper use of portal collection campaigns, are also addressed in a way that applies well beyond the limits of the physician practice space.

Each section additionally includes micro case studies that cover results ranging from increased collection rates to the results of new technology solutions.

The 30-page PDF can be downloaded here.

Topics: Self Pay Account Resolution