All staff who interact with patients should have a general understanding of their organization’s pricing policies or know where to direct patient questions on this topic.
Clinicians are often uncomfortable talking about the cost of the care they provide, and they probably don’t have the pricing information patients are seeking. Self-pay patients and those insured under high-deductible health plans may be embarrassed to talk about the financial strain of big-ticket services such as heart surgery or even a routine colonoscopy.
However, avoiding the cost-of-care conversation is not a good option. Doing so could prompt patients to forego needed care, choose another facility that proactively shares pricing information and financing options, or schedule their procedure but respond angrily to unexpected bills that leave many in a state of desperation.
To avoid such scenarios and contend with rising bad debt, more hospitals are joining the price transparency movement. They’re equipping dedicated staff with financial scripts that guide them in speaking compassionately and with one voice to patients as clinicians lead patients from preregistration through payment.
All staff who interact with patients should have at least a general understanding of their organization’s pricing policies or know where to direct patient questions on this topic. Staff dedicated to discussing pricing policies should have an intimate knowledge of their organization’s policies and pricing processes.
Here are a few suggestions to ensure the financial scripts they are following adequately cover the information patients need.
Tip 1: Put price in context with quality and safety information. Just because savvy healthcare shoppers are looking for low-cost deals doesn’t mean they’re not on a quest for value. You can bet they’ll care about complications and mortality rates if they are about to have open-heart surgery. It’s also likely they’ll take note of patient satisfaction ratings readily available online. Include these quality and satisfaction ratings in your pricing information when available.
Tip 2: Communicate directly. Avoid big words and cut to the chase. Invite questions from patients, but don’t make them ask about self-pay discounts, their out-of-pocket obligation, and other issues they would want to know about. Be ready to answer these questions or describe the process through which patients can get answers. Also, keep in mind the links between poor financial literacy and poor healthcare financial behaviors.
Tip 3: Be as patient-specific as possible. Health plans have long used price transparency tools to produce coinsurance and deductible information specific to individuals. Hospitals could do likewise. Price estimates are based at least partially on averages and norms, but personalization can be achieved by communicating in a patient-centered manner.
For example, respect individual preferences and socioeconomic conditions and fully share information in a timely manner so patients and their family members can make informed decisions. The more patients actively participate in shared decision-making as part of the care team, the greater their understanding of their financial responsibilities for that care.
Tip 4: Explain the difference between charge, cost, and price. To patients, cost is the out-of-pocket amount they must pay for healthcare services—and, for the uninsured, it’s also the price. The charge is generally irrelevant, because it’s the base against which all payers negotiate.
Tip 5: No surprises. Be sure patients understand that the prices provided are estimates and that the actual prices will depend on their medical situations and if unexpected complications occur. The average prices for procedures or services—which are all some transparency programs currently provide—may in fact be misleading indicators of true cost differences. Be sure to cover what is not included in estimates, such as physician and anesthesia fees, so patients know what other bills to expect.
Tip 6: Find out if patients will need help paying for their hospital care prior to providing care. Holding off on financial discussions until after healthcare services are delivered reduces patients’ ability to access Medicaid, charity care, or other financial assistance programs and lowers the odds of receiving payment.
Tip 7: Seek feedback from patients and their advocates. Don’t wait for a Google Alert about an unflattering patient comment about your payment policies. Regularly convene focus groups or enlist past patients or family members as secret shoppers for honest assessments of where your organization has fallen short and what it might do differently.
For more information, contact Parallon Revenue Cycle Services.