Study of top U.S. health systems finds patient billing and revenue cycle management improvement, but multiple challenges ahead

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Study of top U.S. health systems finds patient billing and revenue cycle management improvement, but multiple challenges ahead

Press releases may be edited for formatting or style | August 09, 2019 Health IT
NEW YORK, Aug. 8, 2019 /PRNewswire/ -- An in-depth study, commissioned by patient payment and engagement platform Cedar and conducted by The Health Management Academy (The Academy), found that many health systems are prioritizing patient financial experiences, yet still struggle to simplify patient billing and align it with revenue cycle management (RCM). The study examined practices at 20 of the top 100 U.S. health systems.

Patient billing is often driven by antiquated processes and impersonal experiences, which can lead to consumer confusion. As a result, regulatory pressure has mounted to improve price transparency.

The Cedar and Academy study, which included qualitative and quantitative analyses of 23 senior executives collectively managing more than $89 billion in operating revenue, found that more than half of executives identify consumer-centric financial experiences among their top priorities. In addition, 63% are aligning at least four of the eight points across the pre-, during- and post-care patient financial journey (e.g. scheduling, account creation, billing, final payment).

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However, while the industry has made solid strides, some health systems still need to integrate more consumer-friendly methods of engagement like consolidated bills, more flexible payment plans and pre-care price transparency tools. Specifically, the study data indicated that health systems should continue:

Increasing flexibility in patient payment plans: A strong 82% of top health systems offer flexibility with low- or no-interest payment plans to consumers based on factors like credit scores. However, only 41% offer self-select payment plans, which gives consumers more control over their financial responsibility.

Providing more consumer-friendly resources: A key priority for health systems is offering more accessible resources that help patients understand expected charges. Currently, 65% of health systems have out-of-pocket price estimators for patients before they receive care. That said, a greater amount (80%) are posting chargemasters, which can make obtaining accurate, real-time cost estimations a challenge, as they often don't reflect actual patient responsibility.
Consolidating bills: While many health systems are leveraging alternative billing methods (e.g. patient portal, online billing applications), 35% don't offer a consolidated bill. Of those that do, it usually only includes charges from within the health system (hospitals, providers, post-acute care, home care, etc.). As patients often see many affiliated service providers in one episode of care, most will still receive multiple bills in different formats, at different times, and with different payment terms – adding to patient confusion.

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