How has the pandemic affected consumer attitudes toward patient access? What kind of digital experience do consumers expect from their healthcare provider in 2021? Are patients and providers on the same page when it comes to self-service in the healthcare journey? Providers must answer these questions if they are to improve their digital front door, boost patient loyalty and withstand the financial impact of COVID-19.
While we know that a satisfying patient access experience translates to a stronger revenue cycle, change can feel risky without knowing what consumers really want. Experian Health surveyed hundreds of healthcare consumers and providers to find out what each expects from patient access in 2021, and uncovered opportunities for providers to lay the groundwork for future financial success.
Survey findings: 4 revenue-boosting opportunities for patient access in 2021
1. More control and convenience for consumers
Nearly eight in ten consumer survey respondents want to be able to schedule their own appointments, at any time of day or night, from their home or mobile device. They can already order groceries and view their bank accounts this way – and they want the same level of control and convenience when managing the non-clinical aspects of their healthcare.
Digital patient engagement solutions allow providers to offer consumers the flexibility and accessibility they crave. Patients can schedule appointments online, complete registration from home and pay bills from a mobile device. Convenience also delivers health benefits: no-shows are less likely, and patients find it easier to adhere to care plans. And while COVID-19 remains a concern, self-service options minimize face-to-face contact, keeping staff and patients safe.
2. But don’t deliver convenience at the expense of safety and security
Patients want convenience, but they also want their data to be kept safe. More than half of consumers surveyed, particularly the younger age groups, say they worry about security when accessing their personal details online.
Security can be challenging for providers: they need multi-layered solutions that can adapt to security threats that evolve with ever-increasing complexity, without creating cumbersome log-in processes for patients. But with the right technology, providers can safeguard patient data with confidence.
Experian Health’s patient portal security tools use leading-edge identity proofing, risk-based authentication and knowledge-based questions to reliably verify patient identities. Patients can book appointments, register for care or view their health information. Calls to IT support are likely to drop too, saving staff and patients valuable time.
3. Contactless care requirements are driving long term, systemic change
While many of these changes were already simmering in the background, the pandemic has turned up the heat and accelerated the need for contactless care. Will this be a long-term trend? Both patients and providers believe self-service technology is here to stay and seven in ten providers surveyed say they don’t expect patients to feel comfortable in waiting rooms until at least summer 2021. While face-to-face care will always be important, it seems likely that a digital front door will become the default to make the non-clinical portion of the healthcare journey easier and quicker for everyone.
“As providers expand the use of patient portals, there is a huge opportunity to demonstrate the true value of virtual care – and transform healthcare for the long-term.” – Tom Cox, general manager, head of product, Experian Health
4. The financial conversation between consumers and providers must be based on trust, transparency and empathy
When the final bill bears no resemblance to initial estimates, patients feel frustrated and misled. With deductibles and out-of-pocket expenses on the rise, patients are demanding simple and clear pricing information so they can plan accordingly. Providers that offer consumers transparency, understanding, control and convenience when managing their financial responsibilities are going to have the competitive edge.
Providers can achieve this with clear, upfront and accurate pricing estimates to help patients understand their financial obligations before their visit. Next, support to check coverage and advice on tailored payment plans will provide patients with as many tools as possible as they plan to meet those obligations. Experian Health’s Patient Payment Solutions can check for patient coverage, identify a payment plan(s) that suits a patient’s individual situation, and then make it easy to pay via a mobile device.
Future provider revenue hinges on investment in digital healthcare. A welcoming, convenient and secure digital front door translates to patient loyalty, which in turn can mitigate losses in challenging times. Wherever are in digital patient access journey, there’s an opportunity to improve the experience for patients and build a revenue cycle that not only survives the tumult of the pandemic, but also thrives in the years ahead.
A federal appeals court has ruled against hospital groups in their legal challenge to the CMS regulation that would require hospitals to make pricing information publicly available. The rule is set to take effect Jan. 1.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
The American Hospital Association and several other entities, including some hospitals, filed an emergency motion to block CMS from enforcing the hospital price transparency rule set to take effect Jan. 1. Provider groups are arguing that complying with the rule would shift focus away from pandemic-related efforts.
As 2020 draws to a close and headlines hint that the end might finally be in sight for the pandemic, the healthcare industry is considering COVID-19’s legacy. The sudden shift to contactless care, financial consequences of widespread social distancing measures and changing expectations of the patient experience have upended the world of healthcare and health IT – but which changes are here to stay? And what do these changes mean for the patient experience in 2021?
We asked several leaders across Experian Health for their predictions in the areas of patient access, collections, and identity management, and here is a preview of what they had to say:
“Patients will choose providers that give them control over their healthcare experience”
Patients have more opportunity today than ever before to manage their healthcare experience from the comfort of their own home, whether that be through patient portals, online self-scheduling and registration or online payment tools.
As lockdowns and social distancing prevented patients from presenting in person, providers were forced to offer patients with more options for self-service. Unsurprisingly, this was a move a lot of patients have been waiting for and many welcomed this new technology with open arms.
Jason Kressel, senior vice president of consumer products and analytics at Experian Health, expects that, as patients become more accustomed to this level of self-service, more than half of consumers will change providers in favor of one that offers premium digital healthcare services:
“Providers who can meet patients where they are—through web-based services and via their mobile devices—will have the most success with retaining and attracting patients.”
Online self-scheduling can put patients in the driver seat while also avoiding unnecessary contact while many remain cautious about on-site visits. With access issues removed, the patient experience will improve, in turn improving health outcomes (and providers’ bottom lines!).
“With hospital finances on shaky ground, collections will be a top priority for survival”
As COVID-related unemployment leads to an unstable insurance landscape, many providers are worried about maintaining effective collections processes, and they cannot afford to spend time chasing payments. Guarding against uncompensated care and tightening up the collections process will be essential.
Automated collections software can help collections teams focus their efforts on patients who are most likely to pay, while also helping patients manage their financial obligations with as little stress as possible. Providers can also quickly determine which patients qualify for financial assistance, helping them get them on the right payment pathway for their circumstance without delay. Not only will this provide a much better patient financial experience, it’ll prevent “lost coverage” and allow providers to collect a larger portion of dollars owed.
“The surge in portal usage means providers need to watch out for fraudsters”
What does the rapid growth in portal uptake mean for data security? The speedy rollout of telehealth and other digital services has exposed security concerns for many providers, who fear a rise in fraudulent activity in 2021 as cybercriminals sniff out opportunities to steal patient data.
To protect patient information and avoid costly reputational damage, providers must adopt more sophisticated identity management solutions. By combining cutting edge identity proofing, risk-based authentication and knowledge-based questions, providers can more easily verify a patient’s identity when they log on to their portal, greatly eliminating the risk of fraud.
The answer lies in contactless mobile payments. By making it possible for coffee lovers to pre-order and pay for their morning cappuccino through a mobile app, the company was able to offer a safe and convenient slice of normality during the pandemic. While stores were limited to drive-thru and takeout, customers could still get their caffeine fix, but in an easy, socially distanced way. And customers want convenient and contactless ways to pay – as evidenced by $6.2 billion in quarterly sales. Thanks to the app introduced a few years ago, the company has been able to withstand much of the disruption that’s hit the rest of the industry hard.
Can healthcare providers learn from Starbucks’ strategy? Yes. Social distancing measures and fears about face-to-face contact are preventing many patients from visiting healthcare facilities and it’s becoming harder for providers to collect payments and maintain a steady revenue cycle. Self-service and contactless payment methods are now a necessity if providers want to remain profitable during these uncertain times.
But it’s not just about facilitating payments in the context of social distancing. Even before the pandemic, patients were looking for more convenient ways to manage their out-of-pocket expenses and thinking more like active consumers than passive participants in their healthcare journey. Starbucks’ story shows how prioritizing the consumer experience wins out in the end.
So how do providers accelerate collections, ensure patients and staff remain safe, and keep up with consumer expectations? Here are three ways to use pre- and post-service online and mobile payment tools to optimize both collections and consumer satisfaction:
3 ways to improve the patient financial journey with easy contactless payments
1. Empower patients with upfront payment estimates
Imagine sending patients an email or text as soon as their appointment is scheduled, with a personalized cost estimate, relevant payment options and convenient ways to pay before they even arrive. Healthcare payments could be as easy as ordering and paying for a coffee!
With Patient Financial Advisor and Patient Estimates, providers can do just that. With a single text message, providers can give patients transparency, control and reassurance about what they’re going to owe and how they can settle their bill quickly and easily.
2. Help patients find the right payment plan
The pandemic means finances are tighter than usual for many families as well as many organizations, so helping patients manage their bills and get on the right plan pre-service is especially important.
With a consumer-friendly online portal, patients can check their balances, manage payment plans and apply for financial support at the tap of a button. Quicker insurance checks will also increase the likelihood of faster payments and minimize the risk of claim denials for providers.
3. Make it easy to pay – before or after treatment
Reducing friction at the point of payment is probably the biggest dial-mover when it comes to accelerating collections. If patients can settle their bill at the click of a button, the job is ticked off quickly without too much effort on their part, and with minimal input from providers taff. Why make paying harder than it needs to be?
Consider offering patients safe and secure digital payment methods that they can access anytime, anywhere, both before and after their appointment. Post-service, maintain a positive consumer experience with proactive follow-up, timely account information and options to navigate payments from home, if not already settled.
The pandemic has intensified the need for healthcare payments to evolve. Contactless and mobile payments can keep revenue coming in the door (even when the real doors are shut). And as Starbucks has shown, consumers expect easier ways to pay. Every day that a patient struggles to pay a bill is a missed opportunity for the bottom line.
Find out more about how pre- and post-service contactless payments could help your organization withstand financial turbulence, during the pandemic and beyond.
With high-deductible health plans, larger out of pocket costs, and confusion about medical costs in general, it’s no surprise that patients today face increased financial responsibility. Unfortunately, the current pandemic has introduced an entirely new level of financial responsibility and uncertainty for both patients and providers.
Like many provider organizations across the country, Yale New Haven Health was feeling the impact of the changing healthcare landscape. Patients are finding it harder and harder to pay their medical bills, and more accounts are going to debt. The organization obviously needed to be compensated for their services and improve collections, but it needed to do so in a way that matched its mission and vision of providing high value, patient-centered care.
A few years ago, Yale New Haven Health turned to Experian Health to improve collections with an elevated patient experience.
With Experian Health’s Collections Optimization Manager, Yale New Haven Health was able to score and segment patient accounts based on who has the propensity to pay, determine how a patient could best resolve their bill and then direct them to the appropriate resources for doing so. The organization supplemented this activity with PatientDial, a cloud-based dialing platform that offers inbound and outbound communication options to increase collections.
While these efforts have improved collections for the organization in the past, they have proven invaluable for both the revenue cycle and the patient experience during COVID-19.
Increased patient satisfaction. A billing indicator was included for patients that might be experiencing financial hardship as a result of COVID-19, allowing the organization to hold that particular billing statement for 90 days. After 90 days, those accounts were again reviewed and evaluated for charity care as necessary. Patients have been grateful for the extra time and flexibility for payment during such a stressful event.
Continued collections. With these steps in place, Yale New Haven Health was able to maintain the regular daily statement production and movement of accounts through the revenue cycle for those not experiencing COVID-related hardship. The additional revenue supported the institution and helped to maintain collection levels as close to normal as possible during uncertain times.
Improved communications. Even with the 90-day delay for select accounts, call campaigns with PatientDial continued throughout the pandemic. Connection rates have increased by 5.5% month over month from January to present. Patients are not only pleased with the communications over balances due but are more receptive to attempts to resolve debt as the organization has approached billing-related communications in a more empathetic manner.
A consumer-first healthcare revolution has been simmering for years. Despite efforts to create more human-friendly services, the industry still lags behind other consumer-centric sectors. Patients want healthcare to be simple, convenient and on-demand, but a persistent lack of coordination, accessibility and affordability leaves many struggling to navigate the healthcare landscape with ease. Is this about to change? Has COVID-19 flipped the switch?
The pandemic has prompted people to engage with their own care in a way the industry hasn’t seen before, with a surge in telehealth and virtual care. Infection-control forced much of the patient journey online, while providers were pushed to find new ways to communicate quickly and clearly. Now, those with an eye on the road to post COVID-19 financial recovery are optimizing these digital strategies to meet new consumer expectations and improve patient loyalty.
Embracing digital technology and automation throughout the entire patient journey will be key to patient acquisition and retention. Where should providers focus first?
4 consumer-led strategies to keep patients loyal
1. Prioritize convenience across the entire consumer experience
Eighty percent of patients would switch providers for convenience factors alone – ranking ‘convenient, easy access’ ahead of insurance coverage and quality of care. Creating a digital experience that gives patients the flexibility and simplicity they desire should be priority number one in any patient loyalty plan.
Providers can start by reviewing their digital platforms. Encourage patients to use their patient portal to access information, book appointments and manage their healthcare when appropriate. Telehealth and virtual care solutions can be future-proofed with reliable identity protection, so patients can safely access care from home and not worry about cumbersome log-in procedures.
2. Make patient access…accessible
The patient experience shouldn’t begin with time-consuming forms, long waits and error-prone manual intake processes. Rather, providers can make it easy for patients to complete as many tasks as possible BEFORE they set foot in the office by automating patient access.
Online patient scheduling lets patients book, cancel and change appointments online – which 77% of patients say is very important. It has the potential to reduce delays and no-shows, and can minimize the administrative burden for provider staff. While patients remain concerned about the risk of infection during COVID-19, providers can ease their concerns by reducing face-to-face contact with online pre-registration.
3. Respond to affordability and pricing pain points
One Experian Health study found that the top pain points in the consumer journey center on the financial experience, from shopping for health insurance to understanding medical bills. Patients may be unsure what their insurance covers, whether their deductible has been met and whether they can afford the out-of-pocket costs. By providing clear, upfront pricing information about coverage and financial responsibility, providers can protect their patients from unnecessary surprises and reduce the risk of missed payments.
Self-service patient payment tools can simplify the payment process too: patients can settle their bills anytime, anywhere, and get advice on financial assistance and best-fit payment plans.
4. Personalize the patient experience from end to end
A one-size-fits-all approach doesn’t cut it anymore. Patients are looking for communications and services tailored to their individual needs. That used to be both technically and logistically impossible, but not anymore. Providers today can use comprehensive data and analytics to personalize the entire healthcare journey, from customer relationship management to patient collections.
By combining automation, self-service tools and accurate insights into the patient’s circumstances, providers can help consumers make better decisions about their care and how to pay for it. To ensure data reliability and integrity, providers should consider partnering with a trusted data vendor, who can translate robust, multi-source consumer and financial data into a competitive consumer experience.
There is no question that COVID-19 has changed the way we do healthcare, but the industry is perfectly posed to harness the change in consumer behavior and shift towards greater patient engagement. By bringing together a myriad of digital tools, providers can create a healthcare experience that’s convenient, compassionate and in line with consumer expectations.
Interested in learning more about how we can help your organization welcome new patients through its digital door, and boost loyalty among existing patients?
With just a few clicks, patients can book appointments, speak to their doctor, access billing information and pay for care, all without leaving their homes. Online health services have been a lifesaver for many during the pandemic, and the reliance on digital tools has sky-rocketed over the last few months. But for some older consumers who may be less comfortable using digital devices, this shift towards “healthcare from home” feels daunting and isolating.
Many seniors are not immersed in the digital culture and navigate life just fine without a touchscreen. The sudden shift in healthcare delivery channels has demanded many to venture into unfamiliar technology in a rushed and urgent manner. Others face barriers related to things like dementia, hearing loss and vision loss.
Closing the digital divide
Whatever their age, those left out of the digital loop face a higher risk of missed appointments, delayed care and anxiety about how to get tests and treatment. Providers will want to ensure that all of their digital offerings are designed to help patients of every age access care in a way that works for them. That means creating a consumer experience with pathways and channels to suit different patient needs and expectations, including “analog” options for those who aren’t inclined to learn new technologies.
4 ways to make digital health technology more senior-friendly
1. Use data to determine what’s working and what’s not
The starting point for providers who want to improve seniors’ digital engagement is to understand how they’re actually using it (or not) right now. Non-clinical data can give insights on technology engagement, lifestyle and socioeconomic circumstances across all ages in a patient population. When providers know what patients are looking for, and where the gaps are, they can tailor their services to meet their patients’ needs.
For example, let’s say a proportion of an organization’s older members have smartphones or tablets, but aren’t using them to access their patient portals. It’s likely they have the skills so but may not be aware of the service. This can be solved with a simple omnichannel outreach campaign to provide step-by-step instructions explaining how to get started.
One way for providers to capture useful data is with “Z codes” — the ICD-10-CM codes included in categories Z55-Z65. These identify non-medical factors that may influence a patient’s health status. Utilizing Z codes will enable better tracking of seniors’ needs and identify solutions to improve their health and wellbeing.
Providers can also leverage data to better understand seniors’ activity in the continuum of care. Are older patients continually presenting for care at a facility that is out of network? A tool like MemberMatch can deliver these insights in real time, alerting care teams as early as possible so that they can rally around active episodes of care proactively and efficiently. This helps risk-bearing organizations optimize the quality and cost of member activity in the continuum of care, leading to better outcomes for patients and a better bottom line for organizations responsible for their health.
2. Give patients choices about how they access services
Adoption of healthcare technology is increasing among older adults: 76% of over 50 say they welcome services to help them “age in place”, or live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level. At CareMount Medical, 27% of primary care appointments made using Experian Health’s online scheduling tool are initiated by those aged 60 and over. The demand is there; support should follow.
That said, an omnichannel approach is still important. Given a choice, more than half of people aged 50 and over prefer their health be managed by a mix of medical professionals and technology. This means giving patients the option to easily schedule appointments by phone. Automated outreach and integration, combined with practice management systems, will ultimately make patient scheduling easier.
3. Make virtual care easier to use
More than half of seniors cancelled or delayed appointments due to COVID-19. Despite the promise of safety measures, many are hesitant to return. Virtual care may be the answer.
Providers are quick to learn that telehealth is not a panacea, in particular for the senior population. As some patients may not have the technology and skills to access telehealth, providers may want to consider a hybrid “facilitated telehealth” model where medical professionals visit patients’ homes to help them get set up for telehealth visits.
4. Create a smoother patient financial experience
As older patients become newly eligible for Medicare, many are unclear about their coverage status. To take the burden off the patient, providers should consider a tool such as Coverage Discovery, which allows staff to find MBI numbers quickly. This often proves helpful, particularly for new Medicare beneficiaries who may not have received their MBI card yet.
A way to ease the stress of payments is to offer more transparent pricing so patients know what to expect as they start their healthcare journey. Experian Health’s Patient Financial Advisor gives a breakdown of their bill and payment options, helping them feel financially confident and more in control of their ability to pay – resulting in fewer collections issues.
As older patients become more accustomed to paying for other everyday items through their smartphones or laptops, online patient payment solutions will become less foreign and more convenient, allowing them to manage medical payments in a time and place that suits them.
It’s never been more important to help older patients stay connected, access care and feel supported during their healthcare journey. Contact us to explore how Experian Health’s solutions can help you close the digital divide.
Few of us would buy a new car or TV without
checking the price tag first. Why should our healthcare be any different? Yet
this is exactly what many patients are forced to do when they need medical tests
Following the breadcrumbs on a provider’s
website is a time-consuming and confusing way for patients to piece together a price
estimate. Even with a rough idea of the cost of care, variations in health plan
pricing often bump up the final bill. The lack of transparency is stressful for
patients and costly for providers, who end up chasing slow payments and losing
revenue to bad debt. But could things be about to change?
Many providers have been proactive in
offering transparent pricing, and thanks to recent regulatory changes, this could
soon be an industry-wide requirement. The CMS
Price Transparency Final Rule mandates that by 1 January 2021, hospitals
should publish consumer-friendly pricing information on certain ‘shoppable’
services, to help patients understand and plan their bills ahead of time. The
PRICE Transparency Act would similarly compel providers to publish real
cash prices alongside rates negotiated with insurers. As households, businesses
and public bodies grapple with the economic impact of COVID-19, any additional
clarity around pricing that could help make a dent in healthcare-related debt
is to be welcomed.
Director of Product Management and Patient Experience at Experian Health, says
that regardless of changes to the regulatory landscape, pricing transparency is
here to stay:
“It’s great for the patient because they
have visibility, transparency and clarity about what they owe. They can prepare
financially before their visit, so they can focus on what matters most –
healing. Providers are excited about price transparency tools because they let
patients pick and plan payment options, reducing the total cost to collect. And
with more reliable billing data, it’s a win from a decision-making perspective
Transparency is becoming the norm in other
aspects of healthcare consumer experience, and billing should be no different.
4 steps to fast and simple patient-friendly
1. Remove the guesswork with accurate, upfront pricing estimates
No one wants to play detective with their deductibles. Giving patients pricing information upfront puts them in control of their payments, improving their engagement and increasing the likelihood of faster collections – a top priority for providers today as they continue to feel the effects of COVID-19 on the bottom line.
Estimates tool can generate accurate, easy-to-understand estimates based on
known treatment costs, payer rates and real-time benefits data. Estimates and
secure payment options can be sent straight to the patient’s mobile device,
improving the patient financial experience with a single text message.
2. Give patients 24/7 control through their online portal
pushing even more of our lives online, a 24/7 patient portal is a must for
providers that want to stay competitive.
Yale New Haven
Health (YNHH) used PatientSimple
to give patients a mobile-friendly, self-service portal through which they can
generate price estimates, choose payment plans, and monitor payment
information. Sharlene Seidman, Executive Director Corporate Business Services
at YNHH says patients have welcomed online access:
“ROI is not just
tangible dollars in additional revenue, it’s patient satisfaction and improving
the financial experience.”
3. Minimize delayed payments with quicker insurance checks
Millions of Americans have experienced sudden job
losses or changes to their insurance status in the wake of the pandemic,
causing confusion about their current coverage. Payment delays and denied
claims are an inevitable side-effect. Providers can help by offering fast,
automated insurance eligibility verification, so patients can confirm coverage at the point of
service and take the next steps with confidence.
4. Move to mobile for a more convenient patient experience
Imagine if your patients could have all the information they need about their healthcare account, right there in their pocket. Patient Payment Solutions offer real-time pricing estimates based on provider pricing, payer rates and benefit information, so patients can review their bill at a time and place that suits them. There’s also the option to offer secure and contactless payment methods, so they can settle their bill at the click of a button.
the average family of four could save up to $11,000 a year if they had the
option to choose care on the basis of more transparent pricing. Savings on this
scale mean that demand for clear information about out-of-pocket expenses is
going to soar, whatever happens with price transparency regulations.
Learn how Experian Health can help your
organization support patients and improve collections through more transparent
At this point, it is recommended that hospitals begin to form a strategy for price transparency.
The concept behind price transparency is simple: provide transparency that will help consumers understand medical costs and make informed decisions. Experian Heath’s commitment is simple: provide solutions that benefit the patient and the provider, that improve collections and patient satisfaction.
Despite the majority of elective procedures
being up and running again, patients are still keeping their distance. Nearly
half of Americans say they or a family member have delayed care since the
beginning of the pandemic, while visits to the emergency room and calls to 911
significantly. Patients are avoiding care, but it’s not for the reason
Beyond obvious worries about catching and
spreading the virus, a second concern is becoming apparent: patients are
fearful of the potential cost of medical care. With so many furloughed, laid
off or losing their insurance coverage, medical care has become unaffordable for millions of Americans. It’s especially tough for
those who fall into the coverage
gap, where their income is too high to grant access to Medicaid coverage,
but too low to be caught by the ACA safety net.
If patients continue to delay care, it’s
only a matter of time before their symptoms worsen, leading to more complex and
expensive treatment or even risking their lives. For the hospitals and health
systems with revenue levels at a record low, encouraging patients to return for
routine care is a matter for their own financial survival too.
The answer lies in making sure patients feel safe and comfortable both when they come in for care, and when they look at their financial responsibilities.
5 ways to ease the return to routine care
1. Reassure patients about safety measures before and during their visit
Patients are understandably anxious about
what their visit is going to be like. Will they have their temperature taken?
What should they do if they have symptoms of the virus? Will seating areas be
spaced out and sanitized? Pre-visit communications and proactive
information on arrival will help them feel comfortable and eliminate the shock
factor of seeing more stringent infection control measures.
2. Minimize unnecessary contact by shifting patient intake online
From online scheduling and
pre-registration to telehealth and contactless payment, there are many ways to
keep face-to-face interactions to a minimum. Not only will this help reduce the
spread of the virus, it’ll make the whole patient experience more convenient
for patients. Exploring a virtual and automated patient intake experience can also free up staff to work on other tasks, thus also protecting the
organization’s bottom line through efficiency savings.
3. Encourage patients back to care with automated outreach campaigns
With so much uncertainty at the moment,
patients may be unsure if it’s even appropriate to come in for routine care.
Use automated outreach to prompt them to
book appointments and schedule follow up care. A digital scheduling platform
can help you set up text-based outreach campaigns, to reassure patients that
it’s safe (and essential!) to come in for any overdue care – without placing
any undue burden on your call center.
4. Provide price transparency before and at the point of service
With healthcare experts pointing to financial
worries as a major barrier to care, anything providers can do to improve the
patient financial experience is an advantage. Price transparency is the first step.
When patients have clear and accessible payment estimates upfront, they can
plan accordingly and/or seek financial assistance as quickly as possible,
reducing the risk of non-payment.
5. Screen for charity care eligibility with faster automated checks
Once those payment estimates have been
generated, the next step is to confirm whether the patient is eligible for financial support, in the event that they’re unable to cover their bill. Checking eligibility
for charity assistance is a time-suck for patient collections teams, but with
access to the right datasets, it’s a perfect candidate for automation.
These steps become even more urgent as
providers face the prospect of a ‘twindemic’ – or a surge in COVID-19 cases
colliding with flu season.
By avoiding delays to care, patients can avoid the need for more serious and
expensive treatment further down the line, when hospitals are likely to be
under even greater pressures.
Contact us to find out more about how our
data-driven, automated patient intake
solutions can help make your patients feel as safe and
comfortable as possible, both physically and financially.
With the rise of healthcare consumerism, people are looking to hospitals, health systems, and physician practices to deliver the same user-friendly, digital experiences they receive from other industries. A recent survey found that more than 80% of consumers surveyed believe “shopping for healthcare should be as easy as shopping for other common services.” Specifically, they want streamlined access points online where they can shop for and purchase healthcare, easily make appointments, understand what they need to pay, make payments, and set up payment plans – or even obtain financing for care if the estimated costs exceed their budgets.
These types of digital experiences help providers recruit new patients and keep them engaged, which leads to better outcomes for both the health of the patient and the financial health of the practice. Unfortunately, most healthcare organizations aren’t ready to provide this level of convenience. In part, this is because they have relied on patient portals as their main digital engagement tool to date.
The problem with portals
There are a few reasons why patient portals underdeliver. First, portals are only for patients that have an existing relationship with a provider. However, the patient experience begins when consumers start shopping for care. Relying on a portal alone is a missed opportunity to generate new patient business.
Second, portals don’t mirror what consumers expect from digital solutions. The interfaces are clunky, the functionality is limited, and the technology only supports a pull strategy, meaning that it waits for the patient to come to it rather than periodically reaching out and prompting the individual to take action.
Third, a patient must be logged into a portal before they can do anything with it. This makes it harder to schedule appointments with new physicians because there is not an established connection. In these cases, the patient must pick up the phone, wait on hold, set up an account, possibly wade through insurance approval and pre-authorization, and then make the appointment.
Finally, portals aren’t ideal for communicating costs. While some allow the patient to pay co-pays, they aren’t designed to give realistic cost estimates, offer payment plans, suggest alternative funding sources, and so on.
Taken together, these challenges result in low, inconsistent portal use. Even if a hospital indicates that 50% of its patients access the portal, one-time or limited use should not be viewed as patient engagement. Instead, to realize true engagement, organizations should be thinking about ways to foster two-way conversations to keep new and existing patients focused on their health and how the hospital, health system, or physician practice can meet their needs. This improves patients’ experience and builds loyalty, while also reducing leakage and growing revenue.
What are the risks of poor digital engagement?
Without a well-considered plan for providing a retail-like shopping experience that includes transparent cost information, healthcare organizations run the risk of losing patients. This is especially important as the marketplace becomes more competitive and focused on patient experience, and retail clinics continue to pop-up around the country.
In addition to market changes, regulatory pressures are also making patient-centric financial communications a necessity. Several states are implementing price transparency regulations, and a federal requirement is right around the corner. To meet these standards, organizations will need effective tools that reliably determine and share prices with patients in advance of their appointments.
So where do organizations go from here?
It’s clear that patient portals are not the answer. But how can organizations do a better job of giving patients the convenience they seek? Here are four best practices to consider.
1. Evaluate your organization’s digital tools.
The first step is to take a hard look at the digital solutions you currently provide and compare them to those available from other industries, such as travel, retail, and financial services. Consumers want a digital, retail-like shopping experience where they can search local providers, compare reviews and costs, schedule their treatment, and even pay – all in one intuitive place.
Don’t be fooled into thinking that only younger people want these tools. Research shows that more and more older adults are embracing mobile activities like online banking. In fact, The Harris Poll found that 80% of Baby Boomers (individuals between 56-76 years old) “wish there was a single place to shop for and purchase care.”
Digital tools designed to improve access and transparency while making it easier to pay create more engaged consumers and provide a better patient experience. Achieving this dual dynamic requires digital tools are part of a comprehensive end-to-end solution.
2. Streamline access to shoppable services
These are elective procedures and screening tests that an individual can schedule in advance and include things like planned joint replacements, colonoscopies, and mammograms. Healthcare organizations offer standardized pricing for these services, allowing patients to shop around for the best price, location, and experience.
When patients are able to use a digital tool to research a service, set an appointment, and make a payment, it can drive patient satisfaction and increase the chances the individual will choose to have the procedure with the organization supplying the tool. With 67% of consumers stating they would “shop for healthcare entirely online, like any other products and services,” streamlining access to shoppable services will drive engagement and revenue.
3. Adopt tools that help people understand their care costs.
More than half of consumers surveyed for The Harris Poll said they have “avoided seeking care because they weren’t sure what the price would be.” The biggest hurdle to accessing care is price transparency, resulting in patients not getting the treatment they need and in poor revenue management for a practice.
Patients are more likely to pay their portion up front when they understand what they owe and feel confident that the cost information provided has taken into consideration their current insurance, deductibles, and co-pays. A key to accurate estimates is an automated solution that checks the patient’s insurance digitally, determines the benefits, reviews the amount of any deductible, and verifies whether the individual has already met their deductible. When a patient financial tool also offers the ability to make payments or set up a payment plan, it can increase patients’ propensity to pay, boost the amount of self-pay funds the organization collects, and substantially reduce the cost-to-collect.
4. Enable digital appointment scheduling
Consumers view scheduling and rescheduling appointments as a very difficult task. Digital solutions can address this pain point. Mobile tools and apps that patients can use to schedule appointments monitor wait times, digitally complete forms, and check-in for appointments are essential to breaking down some of the barriers to patient access.
Before onboarding a tool like this, organizations must think through the change management challenges in getting all stakeholders on board. Historically, physicians have been hesitant to open up their calendars to permit digital scheduling. However, transparency and standardization are becoming increasingly important to meet patient demand and are necessary to make these types of tools work smoothly.
Although digital tools are gaining popularity among all generations, there are still people who prefer to pick up the phone to price, schedule, and pay for care. In addition to digital solutions, organizations should have service-oriented call centers to work with these patients. Such centers should have well-trained professionals who are available during and outside of traditional business hours so patients can access the information they need when they need it.
Relying on the status quo is not wise
Healthcare is only going to become more consumer-driven as high-deductible health plans continue to disrupt the industry. Hospitals, health systems, and physician practices cannot afford to rely on outdated technologies that don’t facilitate two-way conversations or the digital experience patients expect. To compete today and in the future, organizations need a comprehensive, retail-like solution that offers a seamless user experience and spans the entire patient journey. Tools and technologies used in combination with putting the patient first will build loyalty while also improving an organization’s clinical and financial outcomes.
About Bill Krause
Bill Krause is the Vice President of Experience Solutions at Change Healthcare. Serving the healthcare industry for over 12 years, Bill leads innovation and solution development for patient experience management at Change Healthcare. In this role, he is responsible for the development and execution of strategies that enable healthcare organizations to realize value through leading-edge consumer engagement capabilities.
Previously, Bill provided insights and direction into new product and service strategies for McKesson and Change Healthcare. He also managed business development planning, partnerships, and corporate development across a variety of healthcare services and technology lines of business for those companies.
Prior to McKesson, Bill worked at McKinsey & Company as a strategy consultant, serving a variety of clients in healthcare and other industries. He received his MBA from Harvard Business School and his undergraduate degree from the University of Virginia. He also served as a lieutenant in the United States Navy.
so many complexities surrounding deductibles, premiums, copays and more, consumers
sometimes struggle to understand the financial components of their health plans
and are often unaware of the out of pocket for their healthcare needs.
Recognizing that confusion about healthcare costs can make it difficult for consumers to ask the right questions, define priorities and take a more active role in their healthcare, Silver Cross Hospital made a point to educate and provide its patient base with health care estimates prior to service being rendered.
the Self-Service Patient Estimates tool from Experian Health, patients of
Silver Cross Hospital now have a consumer-friendly, easy-to-use and accessible
path to obtain out of pocket cost estimates. The Self-Service Patient Estimates
tool works both with the hospital’s electronic medical record (EMR) and as a
standalone tool for the community to use when needed.
Integrating with Silver Cross Hospital’s EMR, the solution calculates estimates based on the hospital’s charge master pricing information and payer contracted rates and utilizes each patient’s individual eligibility and benefits information to create specific out of pocket costs. The tool also allows for detailed and accurate estimate creation using historical claims data to determine the typical procedures and related charges to generate average out of pocket cost estimates by health plan.
via the hospital’s website, the tool acts as a digital front door in the
patient exploratory process. Patients can obtain an out-of-pocket estimate any
time of day or night, and as part of the process are then connected to the next
place of service, whether that be to schedule an appointment, ask additional
questions or obtain more information.
A webinar from HealthSparq offers analysis on a consumer sentiment study on health plans. It offers some useful insights on how the public health crisis has laid bare the trust issues consumers have and how insurers can address them to the benefit of both.
– 8 in 10 consumers said COVID-19 made telehealth “an indispensable part of the healthcare system, according to a new study commissioned by Change Healthcare.
– 2020 Change Healthcare – Harris Poll Consumer
Experience Index reveals 65% said they plan to use telehealth more after the
pandemic, and 78% said COVID-19 has shown how badly the U.S. needs more
A majority of consumers agreed COVID-19 will
fundamentally change healthcare delivery (81%), with most believing the
pandemic will speed digital adoption, according to a new study commissioned by
Change Healthcare. Eight in 10 said COVID-19 made telehealth “an indispensable
part of the healthcare system,” 65% said they plan to use telehealth more after
the pandemic, and 78% said COVID-19 has shown how badly the U.S. needs more
These findings and more are detailed in the 2020 Change
Healthcare – Harris Poll Consumer Experience Index, a national study of
1,945 consumers conducted by The Harris Poll and commissioned by Change
Healthcare. Researchers asked consumers to rate the ease or difficulty required
to find, access, and pay for care across 29 tasks, using an index of 1 to 200,
with 200 being the “hardest” effort, 1 being “effortless,” and anything above
100 being “difficult.” The result: Not one healthcare activity was described by
consumers as effortless. Rather, consumers ranked the difficulty of dealing
with the healthcare system as high as 149, and the average across all tasks at
117. More than two-thirds of consumers said every step of the healthcare
process is a chore, most said they don’t know how much a treatment or visit
costs until months later, and nearly all said they want shopping for healthcare
to be as easy as shopping for other common services—including making it a fully
connected digital experience.
The study, conducted among 1,945 U.S. adults in May 2020,
explored consumer effort throughout the journey of finding, accessing, and
paying for healthcare. The Harris Poll combined all tactical-level attributes
of the journey into a single summary statistic (the Change Healthcare – Harris
Poll Consumer Experience Index) that can serve as a performance benchmark for
healthcare year over year. A reading above 100 indicates the task is generally
difficult for consumers, while a score below 100 indicates it is relatively
easy. The distance from 100 indicates the level of difficulty or ease.
The research segments
respondents and insights into six enrollee groups: those with Medicare
Advantage plans, high-deductible employer-sponsored health plans, other
employer-sponsored plans, individual plans, Medicaid plans, and uninsured. Some
of the research’s other findings include:
– Consumers want accurate cost estimates from payers, and price transparency from providers. More than half (53%) said they avoided care because they weren’t sure what it would cost, 6 in 10 have gone to an appointment without knowing if they could afford it, 68% reported they don’t know how much a treatment or appointment will cost until months later, and an overwhelming 85% said it should be as easy to compare prices for healthcare as it is for other consumer services.
– A majority of consumers (62%) said the healthcare system feels like it’s designed to be confusing, 61% reported their bills feel more complex than a mortgage payment, and two-thirds said they are asked to manage so many care-related tasks that they “feel like a general contractor” when it comes to addressing their healthcare needs.
– One chief request is for a simple, transparent Explanation of Benefits (EOB)/explanation of charges. Only 1 in 3 consumers said their provider and health plan communicate too much. The vast majority said they want their health plan (71%) and provider (68%) to communicate using more modern platforms.
– Consumers overwhelmingly are seeking a retail-like e-commerce experience when it comes to shopping for care: 81% said shopping for healthcare should be as easy as shopping for other common services, 76% said they wish there was a single place they could shop for and buy healthcare, and 67% said they want to shop for healthcare entirely online.
“The majority of consumers said their healthcare experience is a struggle that’s taxing and burdensome, as illustrated through the difficulty they expressed at every phase of finding, accessing, and paying for care,” said Abbey Lunney, director at The Harris Poll. “In an e-commerce world, consumers want the experience of shopping for healthcare to be simple and streamlined. And this has never been more important, as digital healthcare reaches a tipping point amidst the COVID-19 pandemic.”
Medical expenses are often a source of anxiety for many patients, whether they are unsure about the amount owed or how they’ll ultimately pay for it. Unfortunately, intimidating collections processes don’t help, and a crisis like COVID-19 only exacerbates this stress. A more compassionate billing approach could help patients better navigate their financial obligations and also build long-term loyalty—a necessity for providers today looking to retain patient volume during a time of crisis.
Consumers overwhelmingly want to understand the cost of healthcare services, prior to services being performed. Effectiveprice transparency involves offering patients clear, accessible, and easy-to-understand estimates of their financial responsibility for services before they are performed.
Give patients clarity from the start with precise pricing estimates and up-front info about what they’ll have to pay can reduce sticker shock, help them plan and create an overall better patient financial experience.
By empowering your patients with financial expectations, their feeling of control increases, improving their engagement and the likelihood that you will collect payments faster and more efficiently.
Just as you don’t provide identical medical treatment to every patient, processing all patient accounts the same way doesn’t make sense. Every patient is different.
Using comprehensive data and advanced analytics, providers can better understand an individual’s propensity to pay and make the payment process a positive one by assessing and assigning each patient to the appropriate financial pathway based on their unique financial situation.
Medical bills are often the most direct contact providers have with patients after a service is rendered. Unfortunately, money is often a sensitive topic for patients and statements are often overwhelming and difficult for patients to read.
Tailoring communications at each stage can convey compassion and increase patient satisfaction. Customizing patient statements gives providers the ability to simplify and customize bills quickly and easily, turning an often confusing process into one that adds value. Including relevant, personalized messages and educational updates can turn billing statements into a useful resource, all with the potential to drive revenue.
In addition to offering personalized payment options, providers can also find out whether a patient prefers to discuss billing by phone or email.
Minimizing friction at the point of payment is crucial to fostering compassionate collections.
Providers should offer flexible options that include in-person, telephone, mobile and online patient portals, so they can pay in a way that’s most convenient for them. This also frees up staff to help those patients who may need a little extra help understanding their statement.
Want to learn more? Check out Experian Health’s Collections
Optimization Manager which helps providers segment patients based on an
individual’s propensity to pay and payment preferences, informing a
compassionate patient engagement strategy and improving collections.