This post is the first of a series of articles where Health Credit Services weighs in on the Roadmap to the Patient Financial Experience of the Future white papers published by HIMSS Revenue Cycle Improvement Task Force. HCS is the proud sponsor of the 2018 HIMSS RCI Task Force.
The rise in high deductible plans and plan premium costs coupled with the shift of financial responsibility from the employer to the consumer is driving the patient population to carefully consider costs when making health care treatment choices. Long story short – patients have become purchasers and therefore, should and are rightfully demanding value in not only the care experience but also the financial experience.
Hospital system revenue practices are incredibly complex and many times, drive already stressed consumers into a state of overwhelming frustration and exhaustion. The industry recognizes the patient payment experience is broken and is coming together via the HIMSS RCI Task Force to create a vision for the next generation of revenue cycle management.
Transforming Pre-care with Comprehensive Digital Care Platform
Simplicity and efficiency are key for consumers. They expect increased coordination and interoperability between the systems and processes related to in-patient care. Improved coordination and interoperability will streamline processes, therefore reducing the overall cost of the patient and system. The answer? The introduction of an intuitive, comprehensive in-patient digital care platform.
The proposed platform gives hospitals the opportunity to deliver an increased level of price transparency. Hospitals can upload meaningful cost information based on the treatment options suggested by the initial physician into the platform. In addition to cost breakouts, patients can view clinical information across a spectrum of care providers due to the interoperability of EHR/EMR systems into the proposed platform. With cost and treatment in mind, patients then make an educated hospital provider selection based on physician’s privileges, insurance coverage, and available financing.
The ability to electronically exchange financial information within the platform prior to patient admission arrival will streamline the registration process. During scheduling and reservation stages, the hospital deploys an electronic price estimate for services in the platform. This estimate includes access to payment options, financial counselors and payment processing information. Based on the estimate and resources provided, the patient chooses how the financial responsibility will be resolved. The resolution is recorded in the hospital’s patient financial system. Options range from payment in advance of service through structured payment agreements, third-party financing or financial assistance.
Consolidating Post-Care Costs in Digital Care Platform
Shortly after the patient is discharged, the hospital utilizes the platform to deploy one final consolidated bill that details all provider charges involved in the episode of care and clearly states the patient’s total financial responsibility. The patient reconfirms payment arrangements completed in pre-care. Upon confirmation, the patient then receives electronic financial information, payments, receipts and authorization information for providers expected to provide post-acute care services. The proposed plan will consolidate all hospital and provider claims under one specific payer payment model, making it easier for the patient to digest and plan for post-care costs.