The Tangled Web of Google Health – Online Medical Records Could Change Healthcare Receivables Strategies

2. Large hospitals or hospital systems, like the Cleveland Clinic, could partner with commercial PHRs to bring together their systems.

Decentralized billing procedures are the cause of major inefficiencies at many U.S. hospitals. Imagine a hospital system where the urgent care department takes patient payments and insurance in various forms, operates a pharmacy where those same patients will pay for prescriptions, and also employs a handful of primary care doctors who will schedule follow-up visits (and take additional payments) after treatment in urgent care. Paper (in the form of money, credit card receipts, drug prescriptions, and patient medical records) is the bane of existence for many hospitals. Medical errors, financial mistakes, and a costly overreliance on superfluous labor are all symptoms of decentralization.

Were a hospital to pair its ventures in centralized billing with the online platform of a commercial PHR, the hospital could market the broad-based program to consumers, reduce full time employees, and likely improve recoveries on the back end of the revenue cycle. When patients can materially appreciate the transparency of their hospital bill, and see it integrated with their own medical records, greater ownership — of one’s health and one’s share of the responsibility to pay for it –- are likely to follow.

Furthermore, even though the majority of U.S. households now pay at least one monthly bill online, disproportionately few hospitals and physician groups accept online payments. As a hypothesis, consider a restaurant that serves only split pea soup, but you don’t like split pea, or soup in general. In that context, you are unlikely to patronize that business. But if that restaurant served 4 kinds of soup, in addition to sandwiches, salads, desserts, and a variety of beverages, it is logical to assume that you could find something to eat or drink there. The analogy is apropos of hospital payment options; the more choices a hospital gives consumers for how they can pay their bills, the more likely they are to support the business in the first place. Once care has been delivered, multiple payment options mean that receivables are converted to cash in greater amounts and in less time.

3. In recent years, consumers have become increasingly responsible for footing the bill for their own healthcare, and they have become more mobile, shifting from one insurer to another and from one doctor, hospital, or emergency room to another. That’s meant a huge increase in paperwork, and in costs associated with staff filling out and transmitting forms. Online, portable PHRs would decrease the need and associated costs for service providers and patients that attend the “cafeteria style” aspects of the new consumerism in healthcare.

4. A set of analytics to determine candidates for charity care assistance could be built into PHRs, granting increased compliance control with the new IRS Form 990 for hospitals. This would help better identify patients in need of financial assistance before account delinquencies ever come into play.

5. The healthcare debt buying market, still largely in its infancy but poised to expand appreciably in coming years, could reasonably benefit from PHRs. One of the key components often missing from bad debt portfolios is the media that establishes legal chain of title. The absence of such media significantly devalues portfolios for sale, and a centralized, electronic warehouse of this information would boost the potential for hospitals (and debt buyers) to earn revenue from the sale and purchase of healthcare debt portfolios.

6. The federal judiciary has yet to take up the issue of patient privacy rights associated with commercial PHRs. In the absence of any legal precedent, healthcare creditors and their collection agency partners may perhaps discover new inroads—and increased leverage—when patients with the means to do so are reluctant to meet their financial obligations for healthcare debt. In contrast to an antiquated and decentralized system of paper bills and records, hospitals and collection agencies will more easily be able to substantiate their claims for valid debts as a result of PHRs. Furthermore, although relatively few disputes over unpaid medical bills are handled via the court system, collection law firms that do take such cases may well be able to subpoena records for a patient’s medical transaction history from a single source: a commercial PHR system.

Conclusion

The expansion of PHRs in the contemporary healthcare landscape is a foregone conclusion. Patients, healthcare providers, collection agencies, government regulators, and consumer advocates should cease to ask “if” these systems will affect the U.S. healthcare system and begin at once to ask “how” they will do so. More importantly, stakeholders at all levels—and despite mainstream media coverage to the contrary, directors of hospital billing and collections, debt buyers, and collection agencies that specialize in medical accounts are not the least among the interested parties—should endeavor to participate actively in the process of defining the shape of commercial PHRs as they develop to help create electronic record systems that produce the greatest good, both in terms of corporal and financial health.

As an analyst at Kaulkin Media, Michael conducts custom research projects and writes publications focusing on the healthcare sector of the accounts receivable management industry. Contact Michael by email or at 240-499-3836. Be sure to check out his blog in the insideARM blog center.