2017 patient payment check-up
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2017 Patient Payment Check-up
February 20, 2017
Phil Dolan
Chief Marketing Officer
Navicure®
Bryan Fiekers
Sr. Director, Research Services
HIMSS Analytics
What Are We Going to Cover
© 2016 Navicure, Inc. All Rights Reserved. 2
About Navicure
Importance of Research
Research Methodology
Attitudes around Cost Estimates
Attitudes around Bill Payment
Opportunities for Improvement
Key Takeaways
Who is Navicure®
© 2016 Navicure, Inc. All Rights Reserved.
Navicure is a provider of cloud-based revenue
cycle management solutions, each designed to:
Increase Revenue
Accelerate Cash Flow
Reduce the Cost and Effort of Staff
Integrated on a Single Platform
Who is Navicure®
© 2016 Navicure, Inc. All Rights Reserved.
Headquartered in Atlanta, GA
300+ Employees, all US-based
8,000+ Clients, 100,000+ Providers, 350+ Facilities
All Care Settings, including Hospitals, & Practices
Award-Winning Solutions and Service
Best in KLAS, Black Book, Stevie Awards
30+ Leading EMR, PMS, HIS Partners
Allscripts, eClinicalWorks, Epic, Greenway, Nextgen
Healthcare Management Partners
MGMA, HIMSS, AMGA, HFMA, RBMA, HBMA
Partnered with Leading Investment FirmBain Capital Private Equity
The Healthcare Landscape is Shifting
© 2016 Navicure, Inc. All Rights Reserved. 5
• The care delivery paradigm is starting to shift from Volume to Value
• EMRAM shows that organizations are becoming increasingly sophisticated related to technology• Access to data is driving a trend toward consumerism
• Patient financial obligations and patient choice are at the heart of consumerism
This research focused on what patients and providers are expecting from each other related to payments, and how the attitudes and expectations are changing
Data Collection and Analysis
© 2016 Navicure, Inc. All Rights Reserved. 6
To provide insights into behavioral
trends among providers and patients
Through a blinded, web-based, voice-
of-customer quantitative study with
personnel at provider facilities and
patients
In order to create content around
billing and payment challenges
uncovered
Demographics
© 2016 Navicure, Inc. All Rights Reserved. 7
Targeted: Executives, C-Suite, business
office, financial, revenue cycle and IT
leaders at hospitals and healthcare
systems; providers, office managers and
practice managers at outpatient facilities
– Contacts via:
Recruitment: Web survey link open
between January 6 and January 30, 2017
Targeted: Individuals that visited a provider setting (inpatient or outpatient) in the last 12 months
Qualifying criteria:– 18 year old or older
– Not covered by parent or guardian insurance policy
– Does not work for healthcare technology company
Recruitment: Web survey link open between January 16 and January 20, 2017
1,000 Respondents
Patient Provider
553 Respondents
Generally, Patients Feel the Same Responsibility to Pay Healthcare Expenses as Other Professional Services
© 2016 Navicure, Inc. All Rights Reserved. 8
86.1%
13.9%
Do you feel the same responsibility to pay for healthcare services as you do other professional services, e.g. lawyer, accountant,
child care, home contractor, dry cleaners, etc.?
Yes
No
Are patients starting
to expect the same
ability to compare
healthcare services
as they do when they
are shopping for a
vehicle?
Current State: Three Quarters of Organizations are Able to Provide a Cost Estimate, but Patients Do Not Ask
9
25.3%
74.7%
Is your organization able to provide patients a cost estimate upon request?
No
Yes
1.2%
3.7%
3.8%
5.3%
9.8%
76.2%
0% 10% 20% 30% 40% 50% 60% 70% 80%
After I left; before I wasbilled
After seeing the provider,but still in the office
When I checked in
After scheduling appt
Prior to scheduling appt
Never
N = 861
Did you request a cost estimate for your last visit or procedure, and if so, when?
N = 553
Future State: 56% of Patient Respondents Would Request a Cost Estimate in the Future
© 2016 Navicure, Inc. All Rights Reserved. 10
27.9%
16.1%
2.8%
4.6%
5.1%
13.3%
30.2%
0% 5% 10% 15% 20% 25% 30% 35%
No, an explanation of costs with my bill is fine
Sometimes but not always, depending on thepurpose of seeing my provider
Yes, after I leave the office but before I receive my bill
Yes, after seeing the provider, but in the office beforeI left
Yes, when I check in before seeing my provider
Yes, between scheduling my appointment and seeingmy provider
Yes, before scheduling my appointment
N = 1,000
Would you plan to request a cost estimate from your healthcare providers in the future, and if so, when would you find it most useful?
Two out of Three Participants Say an Estimate Within 10% of the Actual Cost is Adequate
© 2016 Navicure, Inc. All Rights Reserved. 11
1.7%
4.1%
11.5%
64.0%
18.9%
0% 10% 20% 30% 40% 50% 60% 70%
Other
Within 30%
Within 20%
Within 10%
Any estimate is helpful
N = 1,000
If you were to receive a patient cost estimate for a procedure or office visit, how close to your actual cost would the estimate need to be considered a good estimate?
Patients Tend to NOT Compare Prices; When They Do it is Impactful
© 2016 Navicure, Inc. All Rights Reserved. 12
No, 86.2%
Yes, 13.8%
Did you compare healthcare prices between potential providers related to your last healthcare experience?
75% Of those that compared prices are between 18 and 34
17.3%
10.8%
26.6%
18.7%
26.6%
0%
5%
10%
15%
20%
25%
30%
<6 7 8 9 10
N = 139
How much influence did your price comparison have?
Of the 25% of Providers Not Providing Cost Estimates, 44% Have No Plans to Provide
13
7.1%
7.1%
7.9%
34.3%
43.6%
0% 10% 20% 30% 40% 50%
Yes, within the next 6 months
Yes, within the next two years
Yes, within the next year
Unsure
No current plan
N = 140
Do you currently have plans to offer cost estimates to improve your organization’s patient experience?
Why not?
Providers Believe Patients are Less Comfortable Submitting Their eMail Address than Patients Report to Be
14
3.6%1.3% 1.6% 5.4%
9.5%
19.9%
58.7%
3.8% 2.9%4.9% 12.7%
19.2%
24.4%
32.2%
0%
10%
20%
30%
40%
50%
60%
70%
1 2 3 4 5 6 7
How comfortable are you with submitting your email address to your providers when requested?
Patients (N = 1,000) Providers (N = 553)
Very ComfortableUncomfortable
If we can accurately predict costs, how do patients want to pay for services?
15
Current State: 90% of Organizations Send Paper Bills Through the Mail; Half of Patients Would Prefer Some Form of eBilling
16
1.8%
0.9%
12.7%
89.2%
4.2%
12.7%
17.2%
17.5%
48.4%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Electronically via text with link to viewbill on a mobile device
Electronically via e-mail and text toview bill wherever I am
Electronically via e-mail linked topatient portal
Electronically via e-mail withattachment to view bill
Paper bills via the mail
How do you (would you) prefer to receive bills from your providers?How does your organization send bills to patients? (select all that apply)
Patient Preference (N = 1,000)
Provider Billing (N = 553)
40.8%
Patients Report Paying Their Full Balance Much Faster than Provider Organizations Report Receiving Full Payment
17
5.2%
51.4%
22.8%
15.9%
4.7%
1.0%
4.2%
14.6%
17.7%
20.8%
18.8%
22.9%
0% 10% 20% 30% 40% 50% 60%
Never paid any of what is owed
Never paid some of what is owed
I have not been billed yet
More than 3 months
Between 2-3 months
Between 1-2 months
Less than one month
How long did you take to pay the full balance of what you owed?On average how long do your patients take to pay the full balance of what they owe?
Patients (N = 96)
Provider (N = 553)
78% of Participants Would Authorize a Credit Card Payment of $200 or Less
18
22.3%
31.7%
46.0%
0% 10% 20% 30% 40% 50%
I would refuse to provide my healthcare provider with my debitor credit card to be charged one time for what I owe, up to
$200, even if it meant that I could not see my provider
I would provide my card to be charged one time for what I oweup to $200 if required to see my provider; however, I would not
feel comfortable doing it
I would feel comfortable submitting my debit or credit card to becharged one time for what I owe, up to $200, after my
insurance company pays its portion. The rest would be billed orpaid via an automated payment plan.
N = 1,000
In order to see the provider, if the office required you to securely store your debit/credit card in its system and charged your card for actual charges up to $200 one time only after insurance pays its responsibility, how
comfortable would you feel?
Providers: Online Bill Pay and Securely Storing Patient Card Information would Reductions in Cost of Collections
19
1.8%
20.2%
22.0%
14.6%
10.2%
12.2%
0% 5% 10% 15% 20% 25%
Other
Secure credit card on file, charging one time upto $200 once patient responsibility is known
Online bill pay
Electronic statements
Consumer credit line, e.g. CareCredit
Automated payment plans
What payment option do you think would be the most likely to create reductions in Cost of Collections?
N = 549
Key Takeaways
20
Patient Cost Estimates
• Provider organizations claim to be able to provide a cost estimate upon request, yet less than 25% of
patients requested one
• Over two-thirds of patients would find an estimate within 10% or more of their actual cost helpful.
Patient Billing
• Providers believe patients are less comfortable providing email addresses than patients report to be.
• Over half of all patients (52%) surveyed would prefer to be billed electronically vs. paper.
• Providers and patients disagree on how long it takes patients to pay.
Patient Payments
• Among payment methods that a provider organization can provide its patients, patients view credit card-on-
file (CCOF) as their preferred method for charges of $200 or less.
• Over three-quarters (78%) of patients say they would provide their debit or credit card number to be charged
one time up to $200 after claim adjudication if asked by their provider.
• Credit card-on-file (CCOF) is viewed by providers as the best way to improve patient collections.
Thank you!
Phil Dolan, Navicure: 770.342.0271/ pdolan@Navicure.com
Bryan Fiekers, HIMSS Analytics: 312-497.6617/ bryan.fiekers@himssanalytics.org
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