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Providers Struggle with Patient Price Transparency, Responsibility

Sixty-three percent of healthcare professionals are feeling the effects of consumerism in healthcare, finding challenges in providing price transparency to patients.

Sixty-three percent of healthcare providers are having trouble providing sufficient price transparency for patients facing a growing financial responsibility, according to a survey by Porter Research and Navicure.

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The survey of nearly 300 healthcare executives, practice administrators, and billing managers shows that patients are responding to their increasing out-of-pocket healthcare costs by becoming more involved in their care. Sixty-nine percent of respondents said their patients actively shop around for care, and 63 percent say their patients are taking a more active role in care interactions.

However, respondents noted that increased patient financial responsibility has left patients confused about who pays for their healthcare. Sixty-seven percent of respondents said patients don’t fully understand how much money they owe versus how much their insurer owes.

Patients are also questioning providers about practice payment policies. Fifty-three percent of respondents said their patients take the initiative to ask when a balance is due, and 43 percent ask about different payment plans.

Organization leaders also face their own challenges with healthcare consumerism, primarily centered on providing patients with the information they want and need about their medical bills.

Eighteen percent of providers said they don’t have patient-facing cost estimation tools, 13 percent said they lack the staff to address issues, and 12 percent said they don’t offer enough convenient payment options such as automatic payments or online bill pay.

However, providers are making some headway in adopting other digital bill pay tools, Navicure said, showing room for further adoption.

In total, 53 percent of respondents have online bill pay via the patient portal, 33 percent have cost estimation tools, 26 percent send electronic statements, and 25 percent securely store patient credit or debit card information.

Additionally, healthcare organizations struggle with delivering the price transparency that could help their patients understand their bills more easily, the survey found. Forty percent of organization leaders said they weren’t sure of their state’s price transparency laws, even though 17 states have mandated that providers make this information available.

A separate survey by HealthEdge showed that increasing price transparency can improve patient satisfaction and help patients with bill pay. Navicure echoed those findings, suggesting that providers who do not know their state’s price transparency laws should educate themselves and then pass that information onto patients.

In addition to price transparency, providers should also make sure they discuss how and when the patient will pay.

Fifty-five percent of the time these discussions happen at the end of appointments. According to the survey authors, however, providers and front-end staff may wish to consider discussing payments with patients prior to the appointment.

“Healthcare organizations need to invest more time with patients in the front office, estimating their cost of care and payment options in order to reduce questions and delays in collecting post service,” the survey authors asserted. By making sure patients understand how much they must pay and how they must pay it, facility staff increase the odds that they will receive payment.

The survey authors concluded by suggesting that providers follow the “Three E’s” of patient financial responsibility.

First, they must assess eligibility, determining what kind of coverage the patient will receive. Next, providers must offer education on the practice’s financial policy, payment plans, and other critical payment information. Last, providers should offer cost estimates and push for full price transparency.

By ensuring patients fully understand their financial responsibility, they can better equip them to make decisions about care access. Ultimately, this may help more patients get access to care that they can afford.

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