HFMA ANI 2009: Vendors focus on collecting receivables

If you're a hospital financial manager, you've probably cut costs to the bone and wrung all the inefficiencies you can find out of your operations. To survive, though, that may not be enough--you've got to get more money in the door. At this week's HFMA ANI conference, there's a horde of vendors offering to do just that.

Of course, healthcare managers are already using in-house or outsourced collections staffers to get payment from defaulted accounts, and harrying health plans to hurry up and pay. A scant few are finding ways to collect co-pays up front or let patients pay their balance online, too. But at HFMA, some vendors are putting a different spin on how to get the job done.

One such service gives hospitals a chunk of patient bills up front, then allows patients to pay their balance, interest free, over 24 months. All patients are eligible, as long as they have a Social Security number. The service, CarePayment, comes from investment management firm Aequitas Capital Management. Once they agree to make payments, patients get a card branded with the provider's name.

Aequitas gives hospitals 85 percent of the billed amount for patients with good credit scores, and for those with less propensity to pay, funds the account after patients have paid reliably for 90 days. If patients default, Aequitas takes the balance due back from future incoming payments.

Other vendors are trying to help hospitals do a better job of pushing hospitals to do their own collections, while getting more money coming in by getting patients qualified for government health programs. Venerable consumer credit organization TransUnion, for example, allows hospitals to score patient accounts and go after the ones that are likely to pay off. "We allow a hospital to determine which 30 percent of their receivables will let them collect 80 percent of their revenue," says Rod Bazzani, executive vice president with TransUnion's healthcare vertical. "That's what collection agencies do anyway."

TransUnion isn't the only firm doing this. Another notable entry is Connance, a vendor backed by credit scoring giant Fair Isaac, Tenet Healthcare and VC firm North Bridge Venture Partners, which is developing a healthcare-related version of Fair Isaac's FICO score. Healthcare Analytics is focused on helping hospitals manage self-pay patients.

Then there's a baker's dozen or so--if not more--technology firms focused on helping execs do a better job of analyzing collections activity and tightening up the ship. For example, software firm Benchmark Revenue Management allows finance departments to look at key measures of productivity for coders and others working with claims, such as how often claims are rejected, and to look for ways to improve their performance. "Hospitals just aren't doing that today," says Tyson McDowell, chief executive officer.

What's interesting, meanwhile, is that with the notable exceptions of Bank of America and PNC Bank--which have bought their own healthcare financial management applications--financial institutions continue to be under-represented at the show. Let's see if that changes if the economy improves on schedule over the next 12 months.