Solving for the out-of-pocket patient payment variable

Re-engage patients by demystifying costs and providing payment plans

Covering the cost of care is a concern for more and more patients due to changing insurance coverage, economic instability, and increasing chronic illness cases. When cost gets in the way of patients’ ability to receive care, nobody benefits. As a healthcare provider, caring for patients is the number one priority, but what happens to your delivery model when patients—who are facing skyrocketing, and often surprising, out-of-pocket costs—decline care or decide to delay or even discontinue treatment? By effectively communicating treatment options and related costs and introducing flexible payment plans, your practice can encourage patients to access the care they need, on a more affordable scale.

Patients’ financial responsibilities are expanding as their insurance coverage contracts, often resulting in higher deductibles, larger co-pays, or uncovered balances. According to Patient Engagement Hit, “Patient out-of-pocket healthcare costs are up 10% since last year, with the net total of patient financial responsibility coming in around $491 billion in 2021.” With a projected increase of 9.9% through 2026, these expenses are only going up, much to patients’ dismay. The burden of increased financial responsibility is forcing many patients to reconsider getting the care they need.  A recent survey conducted by Bankrate and YouGov PLC found that 44% of families with private insurance were likely to avoid medical care due to cost. This conundrum affects providers like you because, as more patients reduce their level of care due to unforeseen costs, your practice could see a decline in patient volume.

The healthcare cost variable

The changing cost of healthcare is a variable that can be difficult for patients to understand and anticipate, let alone solve. Many patients don’t necessarily have access to large amounts of disposable income to pay for healthcare expenses. Inability or difficulty related to making healthcare payments impacts individuals across income brackets. Patient Engagement Hit reports that “In April, West Health and Gallup Poll found that 18% of patients wouldn’t be able to pay for healthcare even if they needed it in that moment. Another 18% of respondents said someone in their household skipped healthcare access because of high patient financial responsibility.” In today’s uncertain economic environment, where many patients are struggling to make ends meet, uncertainty about what healthcare costs will be is forcing patients to rethink their healthcare priorities.

Various factors can precipitate changing and unforeseen healthcare costs for patients.

• More patients are developing chronic conditions that require regular, expensive treatment. As insurance coverage becomes more restrictive—and even unavailable to certain individuals —patients with these illnesses are suffering in silence. Patient Engagement Hit also discovered that “Patients who have lost their jobs—and employer-sponsored coverage—and seen their bank accounts shrink are working to determine how they can access medical care they may need during a pandemic while curbing further financial challenges.” This re-evaluation of care needs impacts both the practice and the patient because if the patient can’t afford the regular care they need, this leads to less engagement with the practice. To make care more accessible to these patients, your practice can offer them customized payment plans and communicate with them about costs before they make their appointments. Setting the payment expectation with the patient upfront creates transparency and addresses their fears about surprise expenses, ultimately improving the provider-patient relationship.
• The popularization of high-deductible insurance plans has also forced patients to question whether visiting their providers will be financially feasible or not. Because these insurance plans often require patients to take responsibility for coinsurance and copayments in addition to the deductible, patients are often responsible for expenses they hadn’t initially anticipated. These unexpected healthcare costs can be difficult to plan for and often catch patients off guard, leading to friction at the point of payment that can be managed with effective communication about what patients’ financial responsibility will be in the first stage of care.
• Insurance coverage cutbacks have limited patients’ access to care. A recent study conducted by HealthCareInsider.com in partnership with YouGov found, “13% of respondents said they could not access healthcare because they did not have health insurance coverage. Of those respondents, 53 percent said they could not afford health insurance coverage.” With expensive healthcare coverage dissuading patients from enrolling, they are now thinking twice about visiting their providers due to the great expense associated with these appointments. Practices that offer flexible payment plans can encourage patients back into the office.

Redefining the patient payment experience

Having transparent communications about cost of treatment can be difficult for practices and patients alike. Practices strive to collect patients’ payments, but often communication about costs and payment options is lacking, leading to surprising bills that can create a negative overall experience. Patients who seek treatment but feel like their provider is not sensitive to the financial aspect may feel frustrated. This type of friction can cause otherwise-loyal patients to switch providers or delay their care due to fear of accruing large balances, often damaging the provider-patient relationship.

Your practice can benefit from establishing payment expectations with patients from the start and offering options that make care or treatment more accessible. Digital payment tools like automated payment plans–where larger costs can be broken into more affordable installments—can take the awkwardness out of inevitable financial conversations and ineffective follow-up communication that often results in lingering balances in accounts receivables. Informing patients about what their balances will be upfront, in a digital agreement, can eliminate the friction of surprise out-of-pocket expenses that can create a bad experience.

Enter automated payment plans

Payment plans in Practice Management Bridge empower patients to make payments in affordable automated installments, reducing the burden of expensive out-of-pocket balances and removing collection agencies—and their associated fees—from the equation. Tailored specifically for the healthcare industry, our payment plan solution benefits practices because it creates recurring revenue. This solution also helps patients pay for medical bills they may not be able to otherwise afford, liberating these debts from sitting with third-party collection companies.

Our payment plan feature is one of many in Rectangle Health’s flagship product, Practice Management Bridge^®, that streamlines the payment experience for providers and patients alike. Implementing this patient financing solution can help your practice remain engaged with patients who may not be able to pay for their care in one lump sum. This payment flexibility offers peace of mind to patients who struggle to pay their bills and creates revenue on which your practice can rely.

References.

1. Granderson, D. (2021, August 2). U.S. out-of-pocket healthcare spending swells to $491 billion, up 10%. Kalorama Information. Retrieved from https://kaloramainformation.com/u-s-out-of-pocket-healthcare-spending-swells-to-491-billion-up-10/
2. Heath, S. (2021, August 4). Patient out-of-pocket healthcare costs balloon by 10% since 2020. Patient Engagement Hit. Retrieved from https://patientengagementhit.com/news/patient-out-of-pocket-healthcare-costs-balloon-by-10-since-2020?eid=CXTEL000000535050&elqCampaignId=20615&utm_source=nl&utm_medium=email&utm_campaign=newsletter&elqTrackId=9d59804a097547f6a627baac34ffa07a&elq=6424adc685fb4e4babd62b788cbaa8e6&elqaid=21497&elqat=1&elqCampaignId=20615
3. S. (2020, October 29). Over Half of Patients Worried About Out-of-Pocket Healthcare Costs. Patient Engagement Hit. Retrieved from https://patientengagementhit.com/news/over-half-of-patients-worried-about-out-of-pocket-healthcare-costs%20
4. Foster, S. (2020, March 12). Survey: As coronavirus spreads, nearly 1 in 3 Americans admit to not seeking medical care due to cost. Bankrate. Retrieved from https://www.bankrate.com/surveys/health-care-costs/

Rectangle Health

Rectangle Health, a leading healthcare technology company, empowers medical, dental, and specialty practices with seamless and secure technology to drive revenue by increasing patient payments and streamlining practice management and payment processing. Since 1993, the company’s innovative solutions have reduced administrative burden and rebalanced the ledger for its thousands of healthcare providers in the U.S., reliably processing billions of dollars in payments annually.

Rectangle Health focuses on keeping practices financially healthy so they can prioritize care. The company’s flagship product, Practice Management Bridge®, interfaces with all existing practice management systems. This innovative platform includes features like contactless capabilities, customizable messages, online payments, patient financing, and Text to Pay that digitize payments and engagement for ease.

Headquartered in Valhalla, New York, Rectangle Health has been repeatedly named to the Inc. 5000 list of fastest growing companies.