By Morgan Haines and Samantha Wyld, Optum
Perception is reality. We hear this phrase all the time. And this statement is no less true in health care. As patients ourselves, we all have different perceptions of our health care providers. These perceptions are shaped by the experiences we have. But have you stopped to wonder what type of experience patients are having at your hospital, physician practice or health system, particularly from a financial experience standpoint?
Why a patient’s financial experience matters
We recently had a client, the CEO of an academic medical center in the South, tell us that one of his goals is to be an organization where everyone has a fantastic financial experience and talks about how good it was, not just about the excellent clinical care they received. The impetus for this goal was the fact that he was tired of being at social events and public settings during which, inevitably, someone would complain to him about how bad his or her financial experience was at his health system.
A poor financial experience can undermine your reputation and the work you have put into providing the highest quality care for your patients. Research shows that your patients’ positive, high-quality clinical experiences can be negated by a single poor billing experience. And the last impression is the lasting impression.
Take, for example, a story recently published in collaboration with Kaiser Health News and NPR. A woman was transported on an air ambulance after she suffered a debilitating stroke. Her doctors and insurer had deemed the flight medically necessary, and she thought her insurer had given preapproval. However, she later received an arguably record-setting bill from the air flight company for over $470,000. With patients bearing more of the financial burden for their health care today, there is too much at stake to have the billing process undermine your patients’ overall satisfaction and experience at your health system.
Where providers are missing the mark
Each organization is dealing with unique dynamics (both internally and externally), policies, challenges, processes, issues, patient populations, politics and other circumstances that can contribute to a poor patient financial experience. Some of our clients have a decentralized front-end scheduling process and disjointed care coordination. This revenue cycle inefficiency makes it difficult for patients to easily schedule an appointment in a timely, convenient manner and sets a negative tone for the patient financial experience right from the start.
Other organizations send multiple statements to their patients that do not marry or consolidate hospital and professional service (lab, imaging, etc.) out-of-pocket balances. Think about your own health care financial experience. You visit your primary care physician. You are told you don’t owe anything upon leaving. Then, three weeks later, you receive an expensive bill with unexpected charges you don’t recognize. Even though you may have received excellent care during your visit, your whole experience is tainted because of the financial disconnect and disparity.
Furthermore, despite the CMS price transparency rule we’ve long argued was too little, too late, many providers are still struggling to consistently provide accurate cost estimates to their patients pre-care. These missed opportunities only continue to fuel patients’ confusion and frustration with the inability to understand their financial obligation.
Upside for those who crack the code
There are many tangible benefits to getting your patient financial experience right. It has been shown that patient satisfaction is directly tied to payment. A Connance study discovered that when patients reported a poor experience with the business office, only 25% paid their bills in full. But, when patients reported being very satisfied with the business office experience, the paid-in-full percentage reached nearly 75%.
A top-tier financial experience also attracts consumers and drives patient loyalty and retention. The same Connance study uncovered that among respondents who rated a hospital’s billing process well, 82% would recommend the hospital, and 95% would return to the same hospital for future elective services.
Finally, a good financial experience can spearhead a more efficient revenue cycle. One of our clients in the Northeast made recent care setting improvements that contributed to a significant increase in outpatient volume. Leadership worried they might have to spend more money on staff to support the volume increase. However, by implementing one, cohesive electronic medical record (EMR) and shifting to a single, centralized billing office that was the right-answer for its patients, the health system was able to accommodate the increase in patient volumes without having to add more staff or incur new costs.
The bottom line is you must be able to bridge the gap between what patients want and what they actually get in their financial interactions with your organization. Provider organizations must work to mirror a high-quality clinical experience with a world-class financial experience for their patients. In the end, happy patients means happy health care leaders.
Morgan Haines and Samantha Wyld are partners in the Eden-Prairie, Minnesota-based Optum.
