Mnet Health News delivers the latest news and information articles for the world of healthcare.

A+ A A-

Care Quality: Is Value-Based Care Working?

Value-based care, the model that bases payments on quality of care, is starting to reduce medical costs and improve patient services, according to a recent survey from Change Healthcare conducted by ORC International.  In fact, the results show value-based care is accomplishing the “triple aim” sought after in the industry, meaning providing better care for consumers, improving population health management plans and lowering health care expenses.

According to “Finding the Value: The State of Value-Based Care in 2018,” the model is reducing unnecessary medical costs 5.6 percent on average while improving care and patient engagement.  Nearly 25 percent of respondents said their savings exceed 7.5 percent.  

“Despite easing or ending of federal mandates, commercial lines of business are investing in value-based innovation, accelerating the decline of pure fee-for service faster than previously projected levels. Indeed, today nearly two-thirds of payments are now based on value,” according to a news release on the survey from Change Healthcare (https://bit.ly/2KcCGyS).

The survey includes 120 payers such as Managed Medicare and Managed Medicaid across multiple regions and organization sizes.  “Payers are finding the positive impact of value-based care as they scale these models—particularly episodes of care—and that’s starting to bend the cost curve in a significant way,” Carolyn Wukitch, senior vice president and general manager, Network and Financial Management, Change Healthcare, said in the news release. 

“However, the demand to innovate at the pace of change is challenging payers. They lack satisfactory analytics and automation to better engage providers, operationalize their models and assess effectiveness overall.”  Additional findings from the survey include:

Nearly 80 percent of payers say they’ve experienced improvements in care quality, while 64 percent report improvements in provider relationships and 73 percent report better patient engagement.

The fee-for-service model is fading at a faster rate than predicted in previous studies, now representing just 37.2 percent of reimbursement, and projected to drop below 26 percent by 2021.

More than half of payers surveyed, however, “are not very satisfied with their current value-based analytics, automation and reporting capabilities—despite the fact that many of these are designed and developed in-house.”

Visit 2018VBCstudy.com to access the complete research report, Finding the Value: The State of Value-Based Reimbursement in 2018. Examples of value-based care models for health care providers are available from the Centers for Medicare and Medicaid Services (http://go.cms.gov/1jxyhoF.)

 

Read more...

Research Shows Growth in Health Care Prices

The prices for a range of health care services are growing more rapidly than economic inflation in the U.S., according to new research published by the Kaiser Family Foundation (KFF).  The research focuses on trends in health care prices, use of services and health care spending in the U.S. versus other similar countries.

Consumers with private insurance experience particularly high increases in costs for services. The KFF also finds that there is “significant geographic variation in prices.”  “For example, the average price of a full knee replacement for those in large employer plans increased from $19,595 in 2003 to $34,063 in 2016, growth of 74 percent compared to a 28 percent increase in general inflation,” it reports.

In New York City, the average cost of the same knee replacement is more than double the cost in the Louisville, Ky., area.  Overall, private insurance prices for inpatient hospital services are significantly more than what is paid by Medicare and Medicaid, and the gap is increasing over time, according to the KFF.

Compared to other countries, the KFF finds that the prices in the U.S. are higher for health care and prescription medications, but use of services, such as physician visits, is lower.  And, the average health care spending per person in other comparable countries is half as much. In the U.S. the average health expenditures per person in 2016 was $10,348, compared to $7,919 in Switzerland and $5,551 in Germany.

The U.S. spent 18 percent of its GDP on health care in 2016, compared to 12 percent in Switzerland.  More information: https://kaiserf.am/2yPwrMa

Read more...

What ASC’s Need to Know About Bundled Payments in a Value-Based Setting

 

Low cost and high-quality service delivery are the hallmarks of outpatient care in today’s value-based setting. Patients are out searching for providers that offer the best care at the lowest possible cost while payers are also driving care in-network due to the high financial burden of out-of-network arrangements.

To remain competitive, surgery centers must come up with strategies to increase reimbursements that will also be beneficial to patients and payers. One game-changing strategy that ASC’s can use is bundled payments. Unlike the traditional fee-for-service model, bundled payments are well suited for care delivered in today’s value-based environment.   

Bundled payments provide greater incentive for patients to approach ASC’s for surgeries and for payers to move more patients to surgery centers. Patients can avoid having to bear extra financial burden in the form of co-pays, deductibles, and high out-of-pocket payments connected to typical fee-for-service payment arrangements. Payers also get to enjoy significant cost reductions from bundled payments compared to the fee-for-service model.

Surgery centers will experience an increase in case volumes as more companies move into the bundled payments markets, especially if insurance companies decide to adopt it as an alternative payment strategy. 

However, bundled payment arrangements are yet to gain significant traction in the ASC space. The trend is poised to become mainstream as an alternative reimbursement strategy. Alternative payment models, which include those bundled, currently account for 30 percent of industry-wide payments made by Medicare.

Bundled payments could be retrospective or prospective. For prospective bundles, the provider is paid a fixed amount upfront by the insurer for all services to be rendered to the patient. The provider is therefore responsible for any additional cost incurred during administering treatment.  

But the most widely-adopted model used by hospitals is retrospective bundled payment. This operates in a similar fashion to the fee-for-service payment in that payers reimburse providers for the claims raised for the services offered to patients under their program. The payment made by the payers is then compared to the agreed bundled target price and any discrepancy is adjusted for. Providers will be reimbursed for payments made below the target price while payments made by payers above the target price will be retrieved.

ASC’s are better positioned to offer bundled payment arrangements than hospitals. This is because they can provide procedures offered at hospitals at high prices for a much lower rate. Also, it is easier for them to monitor their costs unlike hospitals who deal with a larger number of patients; complicating the task of tracking their cost. 

Read more...

Paper Billing Remains Prominent Among Health Care Providers; Price Transparency Improves

 

In a Waystar and HIMSS Analytics study of patients who visited a health care provider in the last year, new trends in price transparency and payments were revealed.  In particular, a majority of providers continue to issue paper statements, and cost estimates at time of service reflect improvement in price transparency, according to a news release on the Patient Payment Checkup Survey.

“Our second annual survey reveals that the health care industry is at a tipping point. Patients want to understand their health care expenses given how much they pay out of pocket,” Matthew Hawkins, CEO of Waystar a provider of revenue cycle technologies, said in the news release.  “At the same time, providers are looking for ways to increase patient satisfaction and simplify their revenue cycles.”

Key findings from the survey, including over 1,000 patients and approximately 900 financial executives in the health care industry, are: Nearly 100 percent of health care executives report that they bill patients using paper statements, however over half of patients said they would prefer to receive and pay their medical bills electronically.

Eighty-five percent of patients responding to the survey felt the same responsibility to pay for health care as they do other services, however less than 20 percent who have commercial insurance plans found it “easy to understand and convenient to pay for” health care costs.  Waystar also finds that cost estimates from their health provider help patients comprehend what they owe. Eighty-six percent of patients who received cost estimates report they understood their payment responsibility, which ultimately helps with faster and easier payment for providers.

However, less than one-third of patients surveyed said they know to ask for a cost estimate at their healthcare provider’s office while 87 percent of health care professionals participating in the survey say that they are able to offer their patients a cost estimate upon request.  “The survey indicates a significant difference between patients and their provider organizations in terms of perceived payment timeliness,” Waystar reports. 

Nearly half (48 percent) of providers said that it takes their patients over three months to pay the full balance of their bill, versus only 24 percent of patients thinking that it takes them longer than three months to pay their balance. “This perception gap may lie in the timing of payer reimbursement.  Patients may believe that they do not owe anything until their payers pay their share,” according to Waystar.

“Our survey reveals that patient consumerism is advancing quickly as organizations adopt advanced payment technology,” Hawkins concludes. “Patients have a higher expectation than they used to have.  It is important that lagging health care organizations improve their patient billing and payment methods faster to remain competitive. 

Patients are already seeking health care from providers whom they trust with both their health and their pocketbooks.  Providers who don’t provide transparency and convenience will be left behind.”

More information: https://bit.ly/2svglBL

 

Read more...

The Path to a Partnership

Mergers and acquisitions in the health care sector are expected to be robust in 2018 and continue to grow based on strong activity in the market, and trends such as the shift to value-based care models.  According to the Corporate Advisory Solutions (CAS) fourth quarter 2017 newsletter (https://bit.ly/2KjAn9R), at press time, mergers and acquisitions in the revenue cycle management sector have “remained consistent and we anticipate seeing a high level of activity in 2018.

Technological advances will dominate the conversation for RCM companies and health care providers. 2017 required health care organizations to respond to several challengaes and transformative trends, including the political landscape change, growing role of technology, and shift to value-based care.  USCB America’s recent merger and acquisition of RevSolve Inc. and J&L Teamworks, two health care-related industry leaders, is an example of this trend and how to stay ahead in the competitive marketplace.

RevSolve, a Scottsdale, Ariz.-based company formerly known as Collection Service Bureau Inc., is led by Chris Becraft. The ACA member company founded in 1964 was rebranded as RevSolve, a firm that prides itself on being “the best-in-class revenue solution for health care providers,” according to a press statement on the merger and acquisition released by the USCB America.

J&L Teamworks, also an ACA International member company, was established in 1990 in Lodi, Calif., as a receivables management services firm that works with hospitals, medical groups, clinics and physicians. The company, which was previously privately owned and managed by two business partners, is now part of USCB’s family of employee-owned companies.  

“In today’s fast-paced and competitive environment, it becomes critical to look for avenues to retain tenured and successful employees and to broaden the services offered to our business partners,” said Albert Cadena, USCB America’s CEO and president.  The companies worked with CAS, a merger and acquisition advisory firm and ACA International member based in Philadelphia, throughout the process.

“In my almost 20 years of providing M&A advisory services to the outsourced business services sector, I have not seen a better fit culturally and operationally than what exists between RevSolve and USCB America,” Mark Russell, managing partner at CAS, said in a news release on the merger.  Cadena said the merger with RevSolve and J&L Teamworks was the opportunity he had been seeking.

“I have been searching for a merger/acquisition with companies who specialize in the health care side of our industry for the last eight years or so,” he said. “This was a direction and a goal we needed to move forward with in order to continue to be competitive in the marketplace, acquire talented employees and also to expand our geographical presence.”  Cadena added that the decision to seek agencies to merge with was motivated by needs of his clients in the health care space.

“Health care providers are seeking a partner to provide an array of services in revenue cycle management,” Cadena said.  “We also saw in the industry that smaller companies were seeking for an exit strategy and the expectations from the health care receivable side were making it difficult for some to compete.”  Meanwhile, Becraft shared his resolution for the future of the company.

“In deciding the next chapter of our 53-year-old company, we looked for a partnership that could bring further depth to our health care revenue cycle services, a commitment to expand our presence in Arizona, and a culture that complements ours and that of our clients,” Becraft said. “We nailed every criterion. We are also proud to now be a 100 percent employee-owned company as part of this merger, which is a tremendous benefit to current employees and a huge competitive advantage to acquiring the best talent for the future.

Our staff are really in top spirits about all of it. As employee owners, they have a chance to have more than just a career; they own part of the business.”  Like USCB America, RevSolve was also reviewing its strategic direction for the past few years and how it could capitalize on opportunities available through working with health care provider clients.

“We too needed to be larger, but more importantly, we need to be able to offer a deeper stack of revenue cycle services to our current and prospective clients,” Becraft said. “We had a lot of criteria that included market facing objectives, but also internal ones such as how can this help our employees grow in their careers with the company.”

With this in mind, RevSolve was faced with three choices, he said … “develop the services ourselves, acquire other companies or merge with a complementary company.”  And, according to Becraft, the merger makes sense given the same trend is going on in the health care market.  “Health care providers are merging at breakneck speed and their needs are growing ever larger and more complex,” Becraft said.

“The most successful revenue cycle companies are expanding their relationships across multiple lines of services with their clients.”  RevSolve and J&L Teamworks join a host of proud Employee Owners at USCB America, who offer a full enterprise of health care revenue cycle and management solutions, according to the press release from USCB. USCB America has been in business for over 100 years and has been an employee-owned company for almost two decades.

“In both J&L and RevSolve I have seen positive feedback for all the employees, as always the unknown is on the minds of all, and it’s up to USCB to continue on its path of bringing [us] all together as one family,” Cadena said. “I have seen a lot of employees excited about growth opportunities and the options to possibly transfer to other office locations.”

When asked his advice for other companies considering a merger, Cadena said start by taking a look at your long-term goals.  “For us it was to strengthen our family of companies and to continue to provide excellent service to our current and future clients,” Cadena said.

Read more...

How ASC’s Can Negotiate for Higher Out-of-Network Reimbursements

In recent times, ambulatory surgery centers (ASC’s) have been confronted with the challenge of effectively negotiating for the highest reimbursement rates on services rendered out-of-network (OON). This was not the case decades ago, specifically in the early 1990s, when providers didn’t have to negotiate on out-of-network services as they were fully reimbursed by payers.

Today, reimbursements for out-of-network services have become very complex. Payers have now developed many tactics to make it difficult for providers to receive their full compensation.

Amongst other tactics adopted, payers now hire vendors to negotiate the lowest reimbursement rates from providers. This has made it possible for providers to be paid very low rates, as low as 20 percent of the compensation due to them, if they fail to actively negotiate for the best rates.

Providers will therefore have to develop strategies to ensure they receive 100 percent of their reimbursements. Here are 2 tips to consider for a successful negotiation:

Be Deliberate and Persistent in Negotiations

When it comes to negotiating for out-of-network reimbursements with payers, providers must be both deliberate and persistent. Vendors hired by payers will do their best to discourage providers from receiving their reimbursements in full.

Vendors receive higher commissions when they successfully negotiate lower reimbursement rates for payers; as such, they would normally develop tactics to out-smart unsuspecting providers when negotiating on behalf of payers. 

Providers must therefore be proactive in the negotiation process. An experienced staff is well-versed in contract negotiation and should see to out-of-network negotiations with vendors. Your center can also recruit experienced out-of-network negotiators to join the company or be contracted to serve as agents for your ASC to negotiate with payers or vendors. 

No matter how long it takes, responding to each counteroffer and following up with appealed underpayments will make a big difference. Be persistent in the negotiation process by making multiple calls, sending emails, and even scheduling meetings to ensure that the highest possible reimbursement rates are received. This strong negotiation process should be employed even if your center has low volume of out-of-network patients.

Appropriate Use of Data

The effective use of data is another strategy that ASC’s need to consider adopting in order to effectively negotiate for higher reimbursement rates. One tactic that payers employ to give the lowest reimbursement rates to providers is offering a different rate for the same procedure previously handled by the provider.

For example, an insurance company that paid 70 percent on a similar case a year ago might want to now offer 40 percent. An ASC can negotiate for the same rate, or maybe even a higher one, if it has data on the previous transaction. 

Payers are often more proactive in collecting and keeping data than providers. Third-party vendors manage their data effectively and use it to negotiate the lowest reimbursements from providers.

Most providers however do not keep track of the data from their previous negotiations; hence the lower reimbursement rates. 

Therefore, if you want to increase your bottom line, learn to be a persistent negotiator and back your strategy with data. When this is done, out-of-network reimbursements can be higher than in-network reimbursements. Your center has the flexibility and opportunity to set higher reimbursement rates that can make up for low rates set by government payers.

 

Read more...

News & Notes

Seminar: Duties of Data Furnishers Under the FCRA

If you furnish data for consumer reports, you know the importance of applying the Fair Credit Reporting Act to your current business practices. ACA International will offer a CORE Curriculum seminar May 10 to help you incorporate the FCRA and Regulation V into your Compliance Management System. Participants will also learn how to recognize alerts and respond to claims of identity theft and fraud. Register here: https://bit.ly/2pInq0t

Health Care Prices Reach Five-Year High

Health care prices in February increased by 2.2 percent compared to 2016 and 2 percent in January, the highest rate recorded since January 2012, according to the Altarum Institute’s latest Health Sector Economic Indicators report.  National health spending increased by 4.6 percent compared to 2016. Altarum also reports the health care sector experienced modest job growth during the first two months of this year. https://bit.ly/2pHptCe

 

Read more...

Health Care Costs Continue to Impact Consumers’ Decisions to Seek Medical Treatment

 

A new national poll shows that the cost of health care continues to impact whether consumers seek recommended medical care or visit the doctor when they are sick or injured.  The survey, from NORC at the University of Chicago and the West Health Institute shows approximately 40 percent of respondents skip medical care and 44 percent said they didn’t go to the doctor when needed.

“The February survey of more than 1,300 adults offers new insights into how Americans feel about the costs of health care and how they report those costs affect their medical decisions and personal finances,” according to a news release from NORC at the University of Chicago, a nonpartisan research institution.

Other findings in the survey include:

About 30 percent of respondents reported that they had to decide between paying for medical bills or essentials such as food, heating or housing during the last year.

More people fear the medical bills that come with a serious illness over being sick (40 percent versus 33 percent, respectively.)

Respondents who said they skip recommended medical care were about two times more likely to fear getting sick (47 percent versus 24 percent, respectively) and the costs of care (60 percent versus 27 percent, respectively.)

“The high cost of health care has become a public health crisis that cuts across all ages as more Americans are delaying or going without recommended medical tests and treatments,” Zia Agha, chief medical officer at the West Health Institute, a nonprofit applied medical research organization based in San Diego, said in the news release. “According to this survey, most Americans do not feel they are getting a good value for their health care dollars, and the rising cost of health care is clearly having a direct consequence on American’s health-and financial well-being.”

Respondents to the survey also avoid medications due to the cost. “About one-in-three respondents report they did not fill a prescription or took less than the prescribed dose to save money. Dental care also suffered. Nearly half say they went without a routine cleaning or check up in the last year, and 39 percent say they did not go to the dentist when they needed treatment,” according to the news release.  They also experience financial consequences due to the cost of health care and medical bills are often unexpected.

Over half of survey respondents said they have serious financial consequences due to the costs of health care. The consequences include using all or most of their savings (36 percent); borrowing money or adding to their credit card debt (32 percent); and lowering contributions to a savings plan (41 percent.)  

Over half of survey respondents also said they received a medical bill for care they thought was paid for through their health insurance and a similar amount said they received bills at a higher amount than they expected. More than 25 percent of respondents said a medical bill was sent to a collection agency within the last year.  

ACA International members may find more information on health care collections and billing practices through ACA SearchPoint™ (https://www.acainternational.org/searchpoint) using the health care tag.

More information on the survey:  https://bit.ly/2GggwWK

Read more...

Top 3 Reasons Why Some ASC’s Fail

In today’s value-based setting, ambulatory surgery centers (ASC’s) are fast emerging as the preferred choice for outpatient surgical procedures. However, research by the Advisory Board shows that since 2009, nearly half of new ASC’s that open also close. 

The reality is that many surgery centers can falter if they fail to pay attention to critical areas of inefficiencies and risk.

Here are 3 common reasons why some ASC’s fail and how they can be avoided: 

1. Failure to Attract Cases with High Reimbursements

The ability of ASC’s to drive high case volume to their facilities has been identified as crucial to their long-term growth. In order to remain competitive in an environment with low reimbursements, ASC’s will need to target more cases with higher profits. 

Relying solely on procedures with low reimbursement rates will not position a center to stay ahead of the competition. ASC’s will need to expand their areas of specialization by adding new procedures with high reimbursements. For instance, procedures such as major spine cases and total joint replacements (TJR) have the potential to generate higher profits.

2. Failure to Prioritize Patient Care

The quality of care delivered to patients must be a major concern for ASC’s. This is becoming more important today considering the shift towards consumerism in healthcare. More than ever before, patient care is taking center stage as being one of the most crucial factors contributing to the success of a surgery center.  

A strong culture of patient care is required in centers to prevent infections, complications and low patient satisfaction ratings. According to Aziz Berjis, DPM, Founder and Director of Glendale Outpatient Surgery Center; the “patient care has to come first.” As long as ASC’s stick with a high level of quality in patient care they will continue to attract more patients.

3. Poorly Managed Contracts

Effectively managing payor contracts is crucial to the growth of a surgery center. However, centers face numerous challenges in successfully managing the contracts they have with payors. 

A common challenge is that ASC administrators are overly burdened with so many tasks that they are unable to dedicate the time and focus needed to effectively manage payor contracts, especially those that are soon expiring.

With careful planning, ASC’s can allocate more time to negotiating payor contracts. This can be done by either forming a team in the organization saddled with the responsibility of payor contract negotiation or by recruiting more hands if the present staff strength is low.

By paying more attention to payor relationships, ASC’s can negotiate contracts that will lead to significant cost reduction. This will in turn enable them to save more money to fund the growth of their centers.

Read more...

Healthcare Spending Expected to Increase at Faster Rate than Gross Domestic Product

The Center for Medicare and Medicaid Services’ Office of the Actuary projects growth in national health expenditures for 2017-2026 will be faster than the projected growth in the gross domestic product, according to a new report.  National health expenditure growth is expected to average 5.5 percent each year between 2017-2026.

“Growth in national health spending is projected to be faster than projected growth in (gross domestic product) by 1.0 percentage points over 2017-2026.  As a result, the report projects the health share of GDP to rise from 17.9 percent in 2016 to 19.7 percent by 2026,” according to CMS.  The prospects for national health spending and enrollment over the next 10 years are expected to be influenced primarily by key economic and demographic factors:

 

Trends in disposable personal income;

Increases in prices for medical goods and services; and

Shifts in enrollment from private health insurance to Medicare that result from the continued aging of the baby-boom generation into Medicare eligibility.

 

“[The] report from the independent CMS Office of the Actuary shows that healthcare spending is expected to continue growing more quickly than the rest of the economy,” CMS Administrator Seema Verma said in a news release. “This is yet another call to action for CMS to increase market competition and consumer choice within our programs to help control costs and ensure that our programs are available for future generations.”

Additional findings from the report, according to CMS, include:

Total national health spending growth: Growth is projected to have been 4.6 percent in 2017, up slightly from 4.3 percent growth in 2016, as a result of i) accelerating growth in Medicare spending, ii) slightly faster growth in prices for healthcare goods and services, and iii) increases in premiums for insurance purchased through the Marketplaces. In 2018, total health spending is projected to grow by 5.3 percent, driven partly by growth in personal healthcare prices.

Medicare: Among the major payers for healthcare over the 2017-2026 period, Medicare is projected to experience the most rapid annual growth at 7.4 percent, largely driven by enrollment growth and faster growth in utilization from recent near-historically low rates.

Private health insurance: Private health insurance spending is projected to average 4.7 percent over 2017- 2026, the slowest of the major payers, reflecting low enrollment growth and downward pressure on utilization growth influenced by: i) lagged impact of slowing growth in income in 2016 and 2017, ii) increasing prevalence of high-deductible health plans, and iii) to a lesser extent, repeal of the penalty associated with individual mandate.

Personal healthcare spending: Over 2017-2026, growth in personal healthcare spending is projected to average 5.5 percent. Among the factors, personal healthcare price growth is anticipated to be the largest factor at 2.5 percentage points, growth in the use and intensity of goods and services is expected to contribute 1.7 percentage points of total growth, and population growth (0.9 percentage point) and changing demographics (0.5 percentage point) account for the remaining growth.

Insured share of the population: The proportion of the population with health insurance is projected to decrease from 91.1 percent in 2016 to 89.3 percent in 2026, due in part to the elimination of the penalty payments associated with the individual mandate and also to a continuation of a downward trend in the offering and take-up of employer-sponsored health insurance.

More information: http://go.cms.gov/2HkbBEP

 

Read more...

3 Strategies to Improve Financial Relationships with Patients

One of the realities that US healthcare providers must face is the increasing number of privately purchased health plans. High-deductible health plans (HDHPs) have low monthly premiums but require patients to pay a high amount out-of-pocket for care.

With yearly out-of-pocket expenses (including deductibles, copayments, and coinsurance) for HDHPs capped at $6,650 for an individualor twice the amount for a family, most patients in the United States find it difficult to offset their medical expenses from a median household income of about $57,600. A survey by the Federal Reserve Board also showed that almost 50 percent of their respondents report finding it difficult to make an unexpected medical expense as little as $400.

This means that the greater financial risk (of default in payments by patients) has been shifted to providers. This situation calls for better financial relationships with patients who now have a significant responsibility.

Here are 3 tips to consider to build a better financial relationship with your patients:

1. Start Financial Conversation Early

Traditionally, providers delay the financial conversation until after care has been given to patients; although the clinical conversation is often initiated earlier on in the process. With the shift towards patient self-pay arrangements, providers need to start discussing patient financial obligations early in the process.

Providers need to open flexible and clear channels of financial communication with patients well before the care has been provided. Conversation on financial responsibilities should also be handled with finesse to prevent a negative response from patients. Payment options available to patients should be clearly stated without any hidden terms and conditions. In a value-based system, this will go a long way in building trust with patients.

2. Understand the Patient’s Ability to Pay

A major challenge with self-pay is that not all patients are alike with regards to their understanding and response to their financial obligations. While some patients understand the provider’s billing process well, others simply do not. In fact, for some, the process is seen as complex and confusing, which makes self-pay a rather tedious exercise.

Being able to understand patients well will help providers determine who needs more help regarding their ability to pay. In-house research can be conducted to segment patients according to their propensity to pay and to personalize the collection approach. Such research should be designed to elicit response from patients in the most transparent manner.

3. Introduce Patient Financing Option 

Identifying those who are most likely to default on payments is not enough. Providers need to introduce flexible payment and financing options to them in a friendly way. With the shift towards consumerism in healthcare, patients expect a “consumer experience” from providers.

Communication with patients about their financial obligations will therefore have to done with personalization in mind. Each patient should be able to access an automated online platform that offers customized information on their financial obligations and the flexible payments plans they can choose from. Providers that offer an outstanding consumer experience to patients will reap the rewards in their bottom line.  

At MnetHealth, we can help build a better financial relationship with your patients. We are experienced at optimizing self-pay collections by offering innovative financial solutions that simplify the payment process for both patients and providers. By leveraging our online platform, patients can access state of the art payment engagement solutions that will greatly benefit your practice.

 

Read more...

News & Notes

Revenue Cycle Trends to Watch in 2018

Medicare alternative payment models, value-based care and hospital mergers are among the top revenue cycle trends to watch in 2018, according to Revcycleintellingence.com. Providers are still in the midst of the transition to value-based care and the strategies for turning away from fee-for-service may continue to change in 2018. This transition will help providers attract patients through affordable, high-quality care in alternative payment models. http://bit.ly/2rkJCB7

 

CMS Announces New Voluntary Bundled Payment Model

The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation announced the launch of a new voluntary bundled payment model in January. “Under traditional fee-for-service payment, Medicare pays providers for each individual service they perform.  Under this bundled payment model, participants can earn additional payment if all expenditures for a beneficiary’s episode of care are under a spending target that factors in quality,” according to CMS. http://go.cms.gov/2qQ7lc3

 

We Want to Hear from You

Pulse is published for ACA healthcare collection agencies to provide current industry information for healthcare providers. ACA International welcomes article ideas and submissions for consideration in Pulse. Ideas may be submitted to ACA’s Communications Department at comm@acainternational.org.

Read more...
Subscribe to this RSS feed