ACO payor models, high-deductible plans present new challenges for upfront collections
ATLANTA, May 24, 2011 /PRNewswire/ -- Craneware, Inc., the market leader in automated revenue integrity solutions, and Fairview Southdale Hospital, a multi-specialty hospital in the Fairview Health Services network, will help patient access professionals understand and prepare for the impact of healthcare reform on front-end revenue cycle processes at the National Association of Healthcare Access Management (NAHAM) 37th Annual Educational Conference and Exposition, May 24-27 in San Antonio, Texas.
During the presentation, "Healthcare Reform: Upfront Collection Strategies to Adapt to a Changing Payor Mix," on May 27, Kelley Blair, senior vice president of Professional Services and Sales Support at Craneware, and Jena Anderberg, South Region director, business services at Fairview, will highlight the important role of upfront collections as patients become more responsible for costs as well as discuss new challenges presented by payor models such as ACOs. Blair and Anderberg will also discuss the role of technology and strategies for adapting to the changes in the payor landscape to reduce bad debt and ensure defensible, transparent pricing practices.
"Technology constraints combined with difficulties in estimating charges correctly and getting buy-in from staff to ask for payments from patients are significant barriers that health facilities must address in the collections arena," said Blair. "Hospitals are facing more payment issues now that consumers are required to pay a larger amount of their healthcare costs upfront."
Industry research shows that consumers are now responsible for a larger percentage of the costs for their care with more than 30 million covered by high deductible plans. According to the Kaiser Family Foundation and Health Research and Educational Trust, 23 percent of employers stated they planned to increase premium shares that their workers have to pay in 2010.
As part of Fairview Health Services, Fairview Southdale Hospital has already begun to incorporate ACO-style payment structures into their contracts with private insurers. Anderberg will discuss the complexity of this new payor system and how her organization is preparing. Anderberg explained, "We are speaking with patients prior to or when they are at the hospital to educate them regarding their financial responsibilities associated with their care. In addition, we are able to provide patients with the opportunity to pay their estimated out-of-pocket expenses or prior balances during those same conversations."
About Fairview Health Services
Fairview Health Services has eight hospitals that serve rural, urban and suburban communities in the Minneapolis area, and is one of the Top 10 Health Systems in the United States, according to Thomson Reuters 100 Top Hospitals: Health System Quality/Efficiency Benchmarks study.
Craneware (AIM: CRW.L, OTC: CRWRY) is the leader in automated revenue integrity solutions that improve financial performance for healthcare organizations. Craneware's market-driven, SaaS solutions help hospitals and other healthcare providers more effectively price, charge and code for services and supplies associated with patient care. This optimizes reimbursement, increases operational efficiency and minimizes compliance risk. By partnering with Craneware, clients achieve the visibility required to identify, address and prevent revenue leakage. To learn more, visit craneware.com and stoptheleakage.com.
SOURCE Craneware, Inc.