Patient Responsibility News

Ensuring Care Access with High Patient Financial Responsibility

Providers can point their patients in the direction of retail clinics or utilize remote monitoring devices to ensure access to quality care despite rising patient financial responsibility.

By Sara Heath

As patient financial responsibility for healthcare continues to grow, providers are looking for strategies that will help consumers overcome cost barriers while maintaining access to high quality services.


According to a recent report from InstaMed, 74 percent of providers reported an increase in patient financial responsibility in 2015. Not only has this shift encouraged the development of patient-centered billing strategies, but it has also led to concerns about the way patients make decisions about the affordability and importance of healthcare.  

Cost concerns may be getting in the way of primary care access, according to a Physicians Foundation poll.

Although 90 percent of patients are satisfied with their care, the poll shows, 25 percent are foregoing treatment due to high out-of-pocket costs.

More and more healthcare is taking place outside of the traditional physician office setting, which may be a positive development for patients seeking lower-cost services. Providers may be able to help patients understand their options and select the best alternative while potentially reducing out-of-pocket spending.  

Encourage care at retail clinics

While traditional providers are still the best option for complex healthcare woes, retail clinics are an inexpensive alternative for minor ailments such as sore throat or an ear infection. These clinics, which are conveniently located in pharmacies or supermarkets, typically offer healthcare services at a lowercost than primary care clinics.

According to a 2016 study by RAND Corporation, patients who visit retail clinics can save an average of $21 per visit. Providers who promote retail health clinics may be able to help their patients reduce their out-of-pocket healthcare expenditures for low-level illnesses.

According to Peter Goldbach, MD, Chief Medical Officer of RediClinic and Health Dialog, these convenient care offerings help expand treatment to a vulnerable patient population.

“Retail clinics make good healthcare more accessible as well as affordable for a broad group of Americans, which means people get the care they need to return to health faster,” he said in an interview.

“Perhaps more importantly, people are getting the care they need in the right setting. That means problems like strep throat don’t find their way to the ER, and this cost avoidance is good for patients and our healthcare system at large.”

However, some research suggests that patients and providers should be wary of over-utilizing retail clinics. While they offer cost-effective options for certain conditions, patients should not visit them if they do not need to. According to the RAND Corporation report, patients can accrue a high out-of-pocket bill if they visit retail clinics when they otherwise could have mitigated the health concern on their own.

Provide telehealth, remote patient monitoring options

mHealth likewise offers alternative, cost-effective methods for healthcare. Telehealth, for example, allows patients to consult providers without the high-costs associated with a typical in-office visit.

According to a brief from the American Hospital Association, healthcare costs associated with telehealth are statistically lower. The Hospital at Home program out of Johns Hopkins Medicine utilized telehealth and remote patient monitoring techniques, resulting in a 32 percent reduction in healthcare costs.

Telehealth also offers flexibility to patients. Because patients connect with a provider via video conference, they can typically receive care at any time and in any place. This allows patients to receive follow-up care from their own computers or smartphones, potentially saving patients money they would have lost by taking the day off from work to visit a physician in person.

Some critics say that healthcare professionals should still be wary of an over-utilization problem. At a March meeting of the Medicare Payment Advisory Committee, which debated the extent to which Medicare should cover telemedicine visits, some said over-utilization could increase healthcare spending.

Similar to some arguments against retail clinics, these critics said that patients may use telemedicine when it they could otherwise allow an ailment to work itself out on its own, resulting in potentially preventable costs.

Connect with patients over the patient portal

Patients may also want to receive care from their providers via the patient portal. Through secure direct messaging, providers can answer quick health-related questions that could save patients a trip to the clinic or hospital. These communications could also help providers direct patients toward their most cost-effective treatment options.

According to a study published in the American Journal of Managed Care, patients with high financial responsibility are likely to access secure messaging. Patients who had to pay $60 or more per office visit were 20 percent more likely to first engage with their providers through secure email.

Ninety percent of those patients would contact their providers via telephone if secure message were not an option.

“As more patients gain access to online portal tools associated with electronic health records, e-mails between patients and providers may shift the way that healthcare is delivered and also impact efficiency, quality and health outcomes,” said lead author Mary E. Reed, DrPH, staff scientist with the Kaiser Permanente Division of Research.

By offering alternative care options – either through retail clinics, telemedicine, or secure direct messaging – healthcare providers can help patients reduce their out-of-pocket costs. As more and more patients assume greater financial responsibility, this may be critical to ensuring patients access they care they need.

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