How information technology can support patient payments

Discussing money with patients is never an easy task. Having the conversation can be extremely difficult. Providers generally like to keep patient treatment and patient financials separate, but it is possible to do both and improve the relationship between providers and patients.

Building these relationships through open, honest communication about pricing prior to treatment is an opportunity to help patients better understand today’s complex healthcare environment, including co-pays and high-deductible health plans.

Many healthcare providers are looking to information technology to facilitate the communication and support to make the challenging discussion easier.

Here are three key components to improving patient pay strategies, leaning on capabilities of information technology.

Customer service built on data
If anything makes the provider’s job easier when it comes to treatment cost transparency, it’s going to be data. Data is buried within providers’ data systems and is available from a variety of external sources. Sometimes it’s easy to access, and other times it’s not. But no matter how a provider gets to the data, it needs it to build an accurate patient cost estimate.

Then, find out how patients want to pay. It’s not enough to take credit cards any longer. Healthcare consumers are used to online, smartphone- or tablet-based payment options for a variety of services and products. If an organization hasn’t already explored online payments, it may be time to do so.

Big data and digital delivery
It’s virtually impossible to provide accurate prices in real-time today without using digital technology to integrate data and manage the many different pricing variables and delivery channels.

Providers that want to stay ahead of patient requests for detailed cost and quality analysis must develop a digital strategy to use existing out-of-the-box partial solutions, such as contract management systems, cost estimators and comparative pricing tools.

The strategy also must incorporate analytics for large datasets, and algorithms and rules engines to automate estimation calculations and their delivery, whether direct to a consumer via a portal, mobile app, to patient navigators and customer-service employees. Finally, it must meet existing and emerging regulatory compliance requirements.

The systems and tools required to execute the digital strategy will help providers deliver the features and functions necessary to create a consumer-friendly online experience:

• Cost-estimation tool for calculating the consumer’s out-of-pocket cost accountability should include other useful features, such as plan information and appointment scheduling.
• Prioritize transparent pricing on elective or non-critical procedures for cost-conscious consumers who are more likely to comparison shop.
• Streamline estimates with payer-specific bundling of episodes of care.

Crystal clear communication
Consumers want simple pricing. Transparency and clear delivery of information to patients should be an urgent initiative for any provider that wants to succeed in an increasingly price-driven industry. Analytics and business intelligence can identify priority areas for pricing transparency, which may include specific types of services with a lot of local competition.

A total cost of care analysis and other exercises also are likely to reveal where and even why a provider is less efficient than a competitor in delivering specific services, leading to higher prices. This information can become the impetus for process improvement, cost reduction and innovation. Those are benefits unlikely to be realized by simply making a third-party cost estimation tool available.

Providers who have put thought into providing quick, clear answers when the consumer asks, “How much?” will be in a better position to thrive in a market-driven health ecosystem. Having a clear rationale for pricing and internal and external processes and tools for sharing and explaining the data will help providers present a compelling story to consumers fully empowered to choose care from multiple providers.

You can build a significant competitive advantage over providers who are slow to accept and adapt to growing price sensitivity and increasing demand for choice from healthcare consumers.