Industry Voices—How loss of coverage is changing patient financial communications during COVID-19

billing statement from a doctor's office
By taking a more proactive, more compassionate approach to patient financial engagement, hospital revenue cycle departments can more effectively demonstrate empathy for the challenges consumers face during COVID-19. (9dream studio/Shutterstock)

During the first half of 2020, 43% of working-age adults did not have stable insurance, and more than one-third faced challenges paying their medical bills, a Commonwealth Fund survey found.

These are findings that point to “a looming crisis in healthcare affordability”—and the need for providers to change the way they approach patient financial communications.

Even before the COVID-19 pandemic emerged in the United States in March 2020, there were signs that consumers were struggling to pay their medical bills. An August 2019 survey found two-in-five Americans would switch physicians to access affordable payment arrangements to cover the cost of their care. More than half had delayed care due to costs.

Now, with 5.4 million Americans having lost their health insurance coverage due to unemployment during the COVID-19 pandemic,  68% of consumers are concerned about their ability to pay for general medical expenses, a recent survey shows. Most would not rank healthcare bills among their top five payment priorities.

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These statistics demand that healthcare revenue cycle departments revamp strategies for patient financial communications and engagement during the pandemic—and progressive healthcare organizations are leading the way. Here are three patient engagement strategies healthcare revenue cycle teams should consider.

Rethink how patients are engaged after estimates are delivered. Months before the pandemic, a consumer survey showed three in four consumers would shop around for healthcare services based on price. Now, as the cost of care weighs even more heavily on consumers’ minds, healthcare leaders must consider: “How can we assure consumers that affordable payment options exist before they delay care?”

During COVID-19 and beyond, healthcare revenue cycle teams should proactively reach out to patients immediately after patient estimates are delivered to ensure that:

  • Out-of-pocket estimates take existing coverage into account
  • Opportunities for financial assistance, such as charity care, are explored, especially if the patient has suffered a job loss due to the pandemic
  • Flexible, affordable options for payment are presented

Reaching out to patients before they convince themselves that needed care is unaffordable is critical. Make sure staff connect with patients digitally or via phone call or text within 24 hours of providing an estimate. Verify that the estimate is an accurate reflection of patients’ out-of-pocket responsibility. Then, walk the patient through the range of payment plans available, from no-interest to low-interest plans, and offer to enroll the patient at the point of contact.

Taking these steps could ease patients’ minds, creating a positive experience that patients will remember after care is delivered.

Give patients a single point of contact in the billing office. This supports continuity in financial care, setting the stage for a seamless patient financial experience. It also gives patients a greater feeling of comfort in reaching out to the hospital’s billing department when financial circumstances suddenly change.

At Atrium Health in North Carolina, the health system eliminates fragmentation in service by providing a single number for patients to call with billing questions, whether for hospital or professional charges. Atrium also provides “Revenue Cycle 101” training for patient financial services staff around how costs are determined so they can have more informed conversations with patients.

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Now is also a good time to take a look at processes for navigating discussions around payment and establishing payment plans. Give staff scripted language for these conversations and consider whether language should be updated in light of the pandemic. Offer self-service and one-to-one support for payment plan enrollment, and provide options for connecting with a patient financial services representative online, via chat or by phone. This meets patients where they are and empowers them to take control of their financial experience.

Engage patients in finding the right approach to payment. One size does not fit all. Offering a variety of payment plans enables patients to pay with dignity, no matter their financial circumstances. At the University of Kansas Health System, leaders revamped the health system’s payment plan model to include long-term, zero-interest patient financing for patients in need. The health system also offers discounts for true self-pay patients—critical during the pandemic. Patients also gain greater ease in managing their medical expenses with the ability to combine hospital and professional accounts into a single plan.

One best practice: Give patients the flexibility to adjust payment arrangements if the size of their monthly payment becomes too much for them to handle comfortably. In a pre-COVID survey, 52% of consumers found the opportunity to lower monthly payments when necessary appealing.

By taking a more proactive, more compassionate approach to patient financial engagement, hospital revenue cycle departments can more effectively demonstrate empathy for the challenges consumers face during COVID-19. It’s an approach that strengthens patient retention and, ultimately, protects the hospital’s bottom line.

Mark Spinner is CEO and president of AccessOne, a leading provider of flexible, co-branded patient financing solutions that help patients afford medical expenses for health systems nationwide.