Striking the balance

They’re caught between two seemingly conflicting business imperatives: Maximizing patient collections while implementing the patient-friendly processes that keep satisfaction levels high.

Thanks to decades of experience, providers have streamlined the process for collecting payments from payers. Unfortunately, many have not yet developed the expertise needed to collect payments from patients without negatively impacting patient satisfaction.

As recently as 2002, a majority of health systems’, hospitals’ and large medical groups’ AR (accounts receivable) was paid by insurance companies—only 10 percent was collected directly from patients. But that’s changing. Today, patients are responsible for a significantly higher share—35 to 40 percent—of their total healthcare costs. With the popularity of ever higher-deductible healthcare plans, that percentage is expected to grow substantially within the next 10 years.

With the burden of risk and financial responsibility shifting, providers increasingly recognize the need to implement the processes, automation and data optimization practices that address the unique challenges of patient collections. Today’s revenue cycle management processes must include an approach that achieves an optimal balance: one that works for patients, protects providers’ reputations, and preserves the all-important relationship between both parties.