A new study from the Healthcare Financial Management
Association (HFMA) – “Self Pay and the Benefits of Prospective PatientEngagement” – finds that more patients are paying healthcare providers
themselves. The study shows that self-pay has “increased by 10 percent during
the last five years,” as high-deductible health plans (HDHPs) have become more
common.
HFMA highlights the following findings from the study’s respondents:
- Patient
payment is rising, with hospitals seeing a 10% increase in self-pay dollars
during the past five years. - More
hospitals have mandatory pre- or point-of-service collections processes for
outpatient services, with that number rising from 9% of hospitals in 2009 to
32% in 2015. - About
20% of respondents indicated “high capabilities for pricing and patient
education related to billing and administrative expectations,” showing there’s
plenty of room for hospitals to educate patients more about this topic. - About
17% of respondents indicated “high capabilities for pre-service automation,
forecasting, and prioritizing financially eligible patient accounts.” - When
it comes to engaging patients about paying for their health care, respondents
rated pre-service pricing as the most important priority. - When
it comes to engaging patients about paying for their health care, respondents
rated pre-service pricing as the most important priority.
In addition to highlighting the impact of changing self-pay
practices on healthcare providers, the HFMA study also notes that the recent rise
of high-deductible health plans (HDHPs) makes payment more challenging for some
patients. The study highlights that 25% of adults with health insurance still aren’t
sure if they can afford to pay for major medical expenses. This is especially
true for adults with HDHPs, and such individuals are “more likely to think about
costs when making healthcare decisions” and “are especially likely to worry
about the effects of healthcare costs of personal finances.”
The concern about patients having the ability to
pay their medical expenses affects healthcare providers as well. HFMA points
out that “Medicaid expansion, HDHP trends, and healthcare provider
organizations’ adoption of improved charity care identification processes and
pre- and point-of-care financial discussions are likely to impact future trends
in bad debt,” and that today “the rate of bad debt is increasing at well over
30% per year” in some hospitals.
insideARM Perspective
This HFMA study points various ways that the relationship
between patients and their medical expenses is changing due to the increased
prevalence of HDHPs. Communicating with patients is key – both about the
expenses associated with a medical procedure and the expectations about how and
when patients should pay for their care.
HFMA also included numerous instructive “Focus
Areas for Self-Pay Process Improvement” that healthcare providers should
consider when determining their self-pay policies and procedures, such as:
- Use
patient-friendly communications and consistent messaging. - Give
patients access to payment estimates at or before time of care. - Engage
with patients early about issues and options when it comes to paying the bill. - Ensure
patients have access to financial counseling. - Learn,
benchmark, and share best practices.
