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When you designed your hospital’s billing statement, did you consult with actual patients to find out what they preferred in terms of content and layout? Many hospitals have relied on educated guesses in the development of statements. But an educated guess is still a guess. As patients become increasingly responsible for and involved in paying for their care, it’s essential that providers treat the billing statement as a core patient communications tool that can enhance revenue or detract from it.
The constant change in the healthcare industry is sparking the need to gain deeper knowledge regarding patients’ perspectives on statements and financial communications. Even before the Affordable Care Act, health care was changing. Market shifts can be acute in how they impact hospital customers—and that should impact the communications, marketing, and other solutions we develop and use to connect with them. This couldn’t be more true for billing and patient statements. As the market has shifted toward consumer-driven health plans with high deductibles and increased patient payment responsibility, overall patient engagement in the financial aspects of care has grown exponentially. I recently helped develop targeted focus groups to get first-hand feedback about what does and does not work in patient statements. The patient focus groups were structured to reveal actionable insights under the supposition that statements can be revenue enhancers or detractors. Communication has an impact on hospital revenue. It’s imperative that patients have positive experiences not just in their clinical care but their financial care, as well.
With a goal to gain direct, knowledgeable insights to develop best practices, the focus groups were segmented to bring in health care “heavy users.” To be qualified to participate, patients must meet the following guidelines:
Across the participant base, a wide range of insurance carriers and many different hospitals were represented. The three groups were separated by age ranges—25 to 44, 45 to 64, and 65 and older—to assess potential age-specific perceptions. The study was blinded so participants had no information about the company conducting the research.
Across all three groups, the study revealed a few consistent, core findings. Patients are not satisfied with the patient billing experience. When asked for words or thoughts to describe their sentiments about statements, patients offered the following comments:
The statement is an extension of the hospital experience. Participants’ opinions of hospitals are influenced by their ability to effectively review and understand the content of the statements. Some participants from all groups stated that they trust their insurance providers to offer what they believe is the most reliable information regarding their care encounters. As educated consumers, patients expressed distrust of hospitals that send unclear bills. Patients also expressed concerns about discrepancies between statements and explanation-of-benefit documents. Patients want clearly conveyed details. The focus groups helped to redefine the term “simplicity” in association with billing statements. While some providers might have interpreted this word to mean a reduction of detail, participants resoundingly stated that, for them, it means clarity of details. Many participants across all groups stated that they rely on phone calls to the hospital to attempt to clarify their charges. They expressed the need for itemization and stated that they wait to receive all the information they need before paying, supporting the supposition that statements play a role in enhancing or detracting from revenue. Well-designed statement summaries can be effective tools. Participants chose the following summary statement as one of their favorites.
Access: Sample Patient Statement After reviewing various strategically designed statements, participants responded with their initial thoughts. These comments were dramatically different from the input offered in response to their overall perception of hospital billing.
Better clarity of information may equate to reduced call volumes or abbreviated, more concise calls, according to feedback from the groups.
Providers need to adopt a strategy of clarity for their billing statements. Patients in the focus groups responded positively to summary pages designed with intention, drawing recipients’ eyes to key information such as amounts owed, due dates, and payment options. However, patients expressed the need for clear details to follow the summary as a means of confirming validity of charges. A full compilation and analysis of the focus groups is currently underway. In addition to offering deep insights into the patient sentiments, the final report on the participants’ comments will delve into details regarding the specific statement features identified as most effective. The groups provided practical perspectives about overall statement design, use of color and bold fonts, placement of call-outs, and order of content. In advance of the final report, the fundamental take-away from the focus groups is that providers should look at the billing process as an extension of their care and their brands. Best practices can lessen the burden on patients, increase satisfaction, and incentivize payments.
Laura Aylward is manager of market intelligence, Emdeon, Nashville, Tenn., and a member of HFMA's Tennessee Chapter.
Publication Date: Wednesday, September 18, 2013
Tom Myers, chief strategy officer, The SSI Group, discusses the shifting payment environment and how it affects providers' patient access and claims management processes.
Jeff Chester, senior vice president and chief revenue officer at Availity, shares his thoughts on "Revenue Cycle 2.0" and how to best meet its challenges.
Mitch Morris, vice chair and global leader, healthcare, Deloitte, and Michael O'Rourke, senior vice president and chief information officer, Catholic Health Initiatives (CHI), share perspectives on the need for transformational IT in health care today.
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
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