In our present financial models of healthcare reimbursement, the setup frequently places the physician and their practice staff in a real predicament. Consumers request that they deliver care during their time of need in a reverent and life-giving manner. Additionally, they are required to collect your co-pay and/or co-insurance while simultaneously understanding your benefit plan, including how much of your deductible you have met.
This interaction creates stress for both parties. It is incredibly inefficient and leads to decreased income on the practice side and increased frustration from the consumer’s perspective. Unfortunately, when a patient arrives for a visit, it is arduous and challenging to guesstimate the type of payment model one has, the amount remaining on one’s deductible, and how to figure it out within the workflow of the visit. Consequently, that leaves the practice attempting to collect their fees on the backside when payment is much less likely, and the resources are potentially unavailable. These dynamics lead to outsourcing the bad debt to companies which only return cents on the dollar and are very disruptive to the lives of those that we serve.
This situation evolved from the current payment models in place and multiple payers that offer numerous plans. Additionally, the present technology prevents both parties in the transaction from rapidly accessing their data. For instance, they cannot quickly determine the amount owed and how much remains in their specific plan concerning their deductible.
To improve these interactions, the root cause of the problem must be addressed. Fundamentally, we need to move away from co-insurance and deductibles to a more simplistic model of co-payments and subscription models. Additionally, there is ample space for third parties to enter this area of financing that might be able to coalesce all the transactions involved and act as the middle layer. Essentially, this type of model is what a credit card company does. If we transition to this method in a manner that is enticing to the patient and one that they can readily access, they will embrace it. Hence, it will improve the biggest driver of poor satisfaction, which is the entire payment process. This latter model will also improve cash flow to practices, even if there is a cost. This additional payment would be much less than the cost of billing and collecting, accompanied by the write-offs that presently occur.
If we sincerely desire to better coordinate the payment methodology with the care we deliver, we must think through all the dynamics and innovate. We owe it to those we serve to enhance the care we provide and make the financial component substantially easier to manage. This change will allow for more significant interactions, thereby leading to improved delivery of services and satisfaction.