Putting Patients First: Highlights from HFMA Healthcare Consumerism Symposium
Industry leaders gathered at HFMA’s 1st Annual Healthcare Consumerism Symposium in Chicago on November 2-3 to share their progress and perspectives on transforming patient financial experience. In a series of focused panels and presentations, speakers from Adventist Health, Gundersen Health System, Hennepin County Medical Center, OSF Healthcare, HFMA and Forrester candidly discussed industry challenges, organizational successes, and a roadmap for the future.
Challenges of Consumerism
The speakers agree that current operational processes, which are geared toward a business-to-business environment, pose a significant challenge to healthcare consumerism. “We’re set up today to bill insurance companies,” says Laurie Hurwitz, Gundersen’s executive director of revenue cycle. “We wonder why that doesn’t work for consumers,” says Joe Fifer, president and CEO of HFMA.
Need for Patient Financial Communication
Fifer shared from his experience as vice president of hospital finance at Spectrum Health, an early adopter of patient-centric billing practices. “Way back in the mid- to late 2000s, we provided an out-of-pocket estimate to every scheduled patient,” he says. “We took the attitude that we need to explain to our community how healthcare finance works.”
Patient financial communication is a key initiative at HFMA today. The organization’s Patient Financial Communication (PFC) Best Practices and adopter recognition program outline steps to help patients understand the cost of services they receive, their insurance coverage, and their individual responsibility. To date, 250 organizations have received recognition as PFC adopters.
High Stakes of Patient Financial Experience
Research indicates that poor financial experience has an impact on health outcomes. “The friction of the financial experience is actually a barrier to people getting access to care,” says keynote speaker Kate McCarthy, senior analyst at Forrester. “If we improve the financial experience, we’re going to see more engaged, happier, more loyal patients with better clinical outcomes.”
Participants shared successful initiatives as well as common obstacles to progress within their organizations:
Hennepin County Medical Center partnered with Simplee to optimize its billing processes and drove double-digit growth in digital self-service in six months, from 20% to 45%. Nio Queiro, vice president of revenue cycle management, emphasizes the importance of technology partners to bridge the gaps. “It’s very clear to us that we’re not prepared to play in this space, and so we have to find good partners who understand it,” she says.
Several organizations have implemented self-service payment arrangements, giving patients the flexibility to determine what they can afford to pay. “The brutal fact is, healthcare isn’t affordable,” says Mike Allen, chief financial officer at OSF Healthcare. “For the piece the patient has to deal with, make that easy and understandable, and broken down in a way they can pay for it.”
Not all patients are alike in their ability or propensity to pay. Hurwitz asks,
“If we know that I always pay my bill the first time and that I can afford to pay my bill, why would that be the first offer?”
Conversely, if someone never pays a bill without a payment plan, they should not be asked to pay the whole bill.
“So I’m looking to figure out what the different buckets of patients are and offering them choices based on what we know their typical behavior is,” Hurwitz says.
Adventist patients can generate self-service estimates, but the majority of estimates today, 35,000 per month, are manually generated. Tim Reiner, vice president of revenue management believes Adventist could improve its self-service metrics by offering real-time estimates. Currently, it takes 24 hours for patients to get an estimate back. “We get thousands of pageviews, but we only have 500 people actually go through and get an estimate back,” Reiner says.
Gundersen Health System plans to take estimates a step farther, and tell patients that if they pay their balance today, Gundersen will guarantee the estimate. “I think that the patients will be just astounded that we’ll tell them a price and we’ll promise to stick by the price,” says Hurwitz.
Changing the Culture
To achieve progress, hospital leaders believe that the culture within their respective organizations must evolve to accommodate the shift to consumerism, as well as to respond to competitive threats. “This transformation is changing us to a retail world,” says Queiro. “We have to learn how to live in that world. We have to continuously educate.”
McCarthy notes that tackling these challenges requires more than buying the right technology. “It’s largely about culture,” she says. “It’s largely about teaching people the importance of things like the financial experience on patient outcomes.”
Other industries are gearing up to solve healthcare’s problems from the outside. David Johnson, CEO of 4Sight Health and author of Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare, commenting on CVS’s recent bid to acquire Aetna and how disruptors could challenge the status quo says, “Just think about the competitive threat that poses, if CVS is suddenly doing a much better job of actively engaging consumers. They’re a retail industry. They do this all day long.”
Fifer, summing up the challenge as well as the opportunity for healthcare innovators, says,
“If we don’t create more of a consumerism mentality and the tools to go with that as an industry, somebody is going to do it for us. I would rather be at the table designing it myself.”
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