How do healthcare providers adjust to the emerging system where patients are responsible for more of their healthcare spending? How do providers collect on unpaid medical bills? How do patients take responsibility for their care and demand accountability from their clinicians? What role does patient education play in the finances of healthcare? In this healthcare roundtable, we touch on all of these topics and more. We were joined by:

  • Wes Pass, Chief Strategy Officer at CarePayment

  • Jeff Ridlehoover, Director of Software Partnerships at Sphere

  • Bradford Crowther, Channel Development and Sales at TransUnion

 


A few highlights from the conversation:

On data in healthcare:

When it comes to data there’s a collection angle, there’s a translation angle and then there’s the usability. Millennials have no problem sharing everything with you and the convenience is more paramount than privacy. And baby boomers are the antithesis of that. We’re kind of at a point where providers are dealing with both of those demographics and what they need.

So being able to collect it effectively, put it out there in a means in which it can be translated and then actually get use from it. I think every provider is hoping for that.

On fixing revenue cycle problems for providers

The patient is going to be more and more obligated for the dollars [and so] over time people will get a little bit smarter. [Providers] have to be better at having the discussion on the front end and collecting a portion – if not all – of the patient responsibility on the front end.

The more you’re able to collect up front the better. Let’s say I’ve scheduled my urgent care appointment and they send me a text to confirm, and oh by the way, it’s going to be your responsibility to pay x. Click here to pay. You’re probably going to collect more that way. You’re not dealing with this post-care scenario.

As the patient becomes the consumer it’s going to shift. One grocery store near me doesn’t take ApplePay, and so now I go to a different one that does. I changed my behavior based on how I paid and they lost a customer and the other store gained one.

On data transparency and price transparency in healthcare

I think at the end of the day you fix health care when everybody is on high deductible equivalent, so catastrophic care with full price transparency, and you make it a real economic model like every other business we have in the US. The solution that came out in January that the government mandated is not enough to get us there […] But in time more of that data will get on the street and somebody will build a model that creates continuity where you can actually search and know your coverage and what it will cost and where you will have to go.

On getting to a consumer market for healthcare

The patient’s financial obligation for a huge length of time was borderline non-existent. A copay is not a deductible. You weren’t spending your money. The patient experience fell apart because the patient wasn’t the customer and still aren’t, the payer is. That triangle has to be reset.

 

If we looked at auto insurance the way we think of health insurance, every time a bird pooped on your windshield you’d expect a free car wash to clean it. But we don’t do that. You get in a fender bender and ask, is that going to cost more than my deductible or not? That’s what I mean realigning healthcare to where the patient is the real customer. This is the reason plastic surgery is so good – it’s more affordable and the patient experience is through the roof.

On the ultimate version of consumer-driven, value-based care

When are people going to start expecting refunds for poor care? You could use one extreme and say, “my heart transplant didn’t work,” and that’s a much different cost perspective. But think about a flu test that said you didn’t have it and you got worse and it turns out you did have the flu. I kind of want my $100 back because they took me down the wrong path.

I wouldn’t be surprised if urgent care start advertising, “see a doctor in 30 minutes or less.” If they start doing things to guarantee a good experience for you, you can demand a refund if that wasn’t the case. I think the challenge is that you’re dealing with the unpredictability of physiology.

 

Photo by Ales Nesetril on Unsplash

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