Financial Counseling

Improved Patient Payments Allow Health System to Reinvest in Growth

February 1, 2018 11:43 am

Hackensack Meridian Health has focused on “compassionate billing” since the early 1990s.

Hackensack Meridian Health, an integrated network of healthcare providers serving patients in New Jersey, was growing even before a June 2016 merger brought together Meridian Health System and Hackensack University Health Network.

It’s one of the largest integrated networks in the area, with 13 hospitals and more than 6,000 physicians as well as a range of facilities, including physician practices, ambulatory care centers, surgery centers, home health services, long-term care and assisted-living communities, ambulance services, air medical transportation, fitness and wellness centers, rehabilitation centers, and urgent care centers.

The system will continue evolving to address market demand and competition. For example, in 2017, the organization announced a partnership with Memorial Sloan Kettering for cancer research, and as the new year began, it completed its merger with JFK Health. Hackensack MeridianHealth also plans to open a medical school in 2019. But none of this growth is possible without a steady stream of revenue collection. Leaders at Hackensack Meridian Health understand that patient payment is just as vital as revenue from private and governmental payers.

Emphasis on Compassionate Billing

During the 1990s—well before the Affordable Care Act and the IRS’s 501(r) requirements—the organization focused on “compassionate billing” with various self-pay strategies to make health care affordable. Demands on patient obligations have increased significantly since then. Today’s healthcare environment has patients facing higher copayments, coinsurance, and deductibles. In fact, patient out-of-pocket costs have risen from an average of $2,000 per year to more than $6,000 in the past few years.

The health system first developed an in-house long-term payment program, but it didn’t materially reduce bad debt from patient pay. The program also was difficult for the organization’s patient financial services team to manage, resulting in lower patient adoption. In addition, staff lacked uniform ways to estimate appropriate terms and payment amounts, resulting in wide disparities in patients’ payment terms.

In 2016, Hackensack Meridian Health engaged a healthcare revenue cycle service provider for its patient loan program. The goals were to solve bad debt problems, create consistent processes for the financial services team, and make it easier for patients to pay their costs of care. The result: a patient-friendly loan service that yields financial improvements and boosts satisfaction.

A Two-Step Program

Today, the Hackensack Meridian Health team addresses increases in patients’ financial responsibilities by having information readily available to make patient decisions easier. Key aspects of the program include:

  • Having conversations with patients sooner in the process
  • Offering many payment options

Early Communication About Financial Obligations

Although patients today face much higher deductibles, they want to understand and fulfill their financial obligations. With that in mind, Hackensack Meridian Health’s customer service team is dedicated to meeting with patients up front to talk about their financial obligations and available payment options. Often, this interaction occurs via preservice phone calls. Financial counseling also is offered during the patient check-in process.

Hackensack Meridian Health promotes price transparency and has published costs for the top 200 procedures geared toward self-pay patients. The team also provides price estimates by physician, procedure, and health plan. Technology has improved staff efficiency and professionalism by enabling staff to offer payment options early in the process.

Payment Options

Working with a loan service provider enables the health system to better match monthly dollar amounts with terms. Hackensack Meridian Health’s financial counselors use the service provider’s online payment calculator to give patients cost ranges and term lengths. The information is presented in a “green-yellow-red” dashboard approach that is visible to counselors. The color codes help them achieve the right balance of offering the shortest repayment terms with monthly payment amounts that are affordable for patients. Patients can consolidate medical costs for their spouses and dependents into a single payment plan.

The tool recalculates and adjusts the monthly payment amounts and term lengths. Using the tool also takes emotion out of the process and helps financial counselors provide clear, comprehensive options for patients.

Post-Care Assistance

Along with the up-front approach to patient discussions, Hackensack Meridian Health’s customer service department also provides support on the back end. If patients need financial assistance after receiving care, customer service representatives work with them to find solutions.”

Measurable Results

Hackensack Meridian Health began offering the long-term loan program at eight of its 13 hospitals in 2016. In less than a year, the health system helped patients cover almost $3.5 million in medical costs, cut bad debt from patient pay in half, and achieved an ROI of 380 percent for the loan program. Patient loan adoption rose steadily in 2017.

Hackensack Meridian Health added hundreds of thousands of dollars per month to the hospital’s bottom line, and patient satisfaction with the loan program is high. The health system is allowing more patients to receive care, while continuing to invest in growth.


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