The Journey

Transforming the Patient-Provider Experience

Written, edited and curated by Loyale founder Dan Peterson, The Journey explores ideas and innovation to enrich the patient-provider relationship

Hospital Billing Practices are Under a Microscope and Providers Are Responding to the Public and Political Scrutiny

Posted by Kevin Fleming, Chief Executive Officer on Oct 22, 2019 11:39:42 AM

Several prominent healthcare providers and investors have been featured in recent, damaging national news stories about patient billing and collection tactics. But some hospitals are learning that improved transparency and communications make it possible to partner with patients to increase revenues and burnish their reputations.


In recent months, U.S. news media have been paying closer-than-usual attention to the ways hospitals bill and collect from patients. The issues range from surprise bills to overzealous collection methods that have gone so far as to seize paychecks and tax refunds - even claim homes. This scrutiny has fueled mounting public anger, prompting U.S. lawmakers to launch an investigation into provider billing practices. The focus of this anger has also expanded to include the private equity owners of some U.S. healthcare companies.


These forms of behavior turn the provider-patient relationship on its head – from care giver to financial adversary. Even more damaging, aggressive collection tactics frighten prospective patients. Concerned and uncertain about what they will owe and how they will pay for the care they need; many decide to skip care entirely. Research results vary on this topic, but the number of people who avoid or delay care because of concerns about their ability to afford it range from fifty percent to sixty-four percent.


There are two sides to this story. Healthcare providers are in a tough spot, too. They are expected to deliver exceptional clinical care and required to meet high regulatory standards. At the same time, they are struggling to collect from financially burdened patients with systems that were developed decades ago to collect from insurance companies. The solution to this problem, it seems, depends on providers’ willingness to abandon adversarial tactics and embrace a more personal, compassionate approach.


Healthcare in a Consumer-Driven Market: Brand Matters


You may have heard the expression, “there’s no such thing as bad publicity”, but ask any executive in an industry that relies on the good will of the buying public and they’ll tell you otherwise. Trusted companies like Disney, Apple, Nike and others spend untold millions in time and money to maintain, protect and grow brands that cultivate long-term consumer relationships. How these companies are perceived in the marketplace is fundamental to their continued success.


Healthcare now finds itself in a similar spot. When the insurance companies did most of the paying, a hospital’s brand was primarily clinical in nature and the financial experience didn’t matter that much. Patients chose the providers that were in their plan’s network, the provider delivered treatment and the payer paid. But now that patients are on the hook for so much more of the cost, they’re behaving differently. Suddenly, a provider’s reputation matters. In such an environment, suing patients to collect from them and other aggressive collection tactics have no place in a business building strategy.


Instead, more and more providers are developing consumer-centric, retail-like experiences. Recognizing that patient preference will be the principle driver of volume and revenue, they’re reimagining the patient experience from new, much larger perspectives. HCA Healthcare is one example. One of the largest and most successful healthcare brands in America, HCA is focused on constantly improving the patient’s financial journey.


Loyale Healthcare has partnered with over 12,000 healthcare facility customers representing in excess of $50 Billion in annual net patient revenue and forty million patient encounters. With a focus on delivering end-to-end functionality, our solution supports six key patient financial elements, all of which contribute to improved patient financial experiences and provider brand value:


  1. Price transparency – One of the biggest problems facing the healthcare industry’s transition into a consumer-first operating model is its pervasive inability to provide patients with reliable upfront estimates for care. In every other purchase decision we consumers make, price is one of the most important considerations. Until now, healthcare has been exempt, but those days are numbered. The government and powerful new competitors like Haven Healthcare, CVS Health and others will see to that.
  2. Payment planning – When a patient knows early what their care is likely to cost, and how much their out-of-pocket will be, they can plan for the expense. With Loyale’s Affordability Workbench™, patients have access to multiple payment options that include discounts for early or prompt payment; short-term, no interest payment schedules; or longer-term payment plans through a third-party lender. Serving themselves online, or working with hospital staff, patients can get the care they need while focusing on payments they can afford, not just worry about what they’ll owe.
  3. Personalized digital & human communications – Patients are often slow to react to traditional hospital billing communications. Whether sent by mail, email or online over the hospital’s patient portal, these form letters do nothing to engage patients or provide the clarity they need to understand and act on their financial obligations. Loyale’s personalized digital communication platform, on the other hand, automatically segments patient populations. By integrating with patient preferences, we then deliver the right messages at the right frequency over the right channel – email, text, chat or initiating a human conversation.
  4. One Bed. One Bill – Ask most patients and they’ll tell you... they’re confused, frustrated and angry about their healthcare bills. “It was one stay in one bed for one thing. Why did I get eleven bills?” With the Loyale platform, Providers can now consolidate bills into one, comprehensive virtual “bill” presentation that patients can understand and act on. Loyale’s underlying technology takes care of making sure the payments get where they need to go.
  5. Seamless, holistic experiences – Healthcare has long separated patient experiences into two different categories; the clinical and the administrative/financial. But patients will tell you that they have just one care experience, and that experience includes every interaction the patient has with the provider, every time. That’s why Loyale integrates with the Provider’s clinical portal. Additionally, its provider-facing portal gives hospital staff and call centers the patient’s account view for easy problem solving.
  6. Provider facing tools to improve productivity and increase revenues – Beginning well before treatment, the Loyale patient financial engagement platform collects and aggregates data to qualify patients. Then the system automatically generates intelligent workflows that reduce staff work and improve the probability of patient payment. Additionally, the tool’s highly configurable reporting and dashboard functionality is now giving health systems the “best visibility into patient-pay revenue cycle they have ever had”. This invaluable business intelligence is making is possible for leadership to find and promote best practices and tackle underperforming practices.


By delivering patient-first financial experiences, healthcare providers across the country are finding that patients are eager to engage with an improved financial experience. This leads to dramatic increases in patient self-service, reduced costs for traditional paper billing and collections and higher patient-pay revenue. Best of all, it responds to patient expectations for transparency, clarity and inclusion. By partnering with them in the financial dimension of care, healthcare can now provide patients and their communities with healthcare financial experiences they can understand and control.

Topics: patient experience, healthcare consumerism, patient affordability, patient portal, Healthcare Technology, Patient Financial Engagement

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