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COVID-19 Elevated Consumerism, How University Hospitals Is Responding
A revenue cycle leader at University Hospitals shares the keys to success with healthcare consumerism and improving the patient financial experience.
Intuitive navigation and a system-wide effort are key to improving the patient financial experience and patient collections in a consumer-driven, post-pandemic world, according to Kathy LeBrew, chief system revenue cycle officer at University Hospitals in Ohio.
“We need to recognize what's important to the patient as a consumer, caring about what they care about, including convenience, affordability, and being seen when they want to be seen. Then, having access the way that is important to the consumer, which will take thinking outside of traditional means of healthcare,” LeBrew recently told RevCyceIntelligence. “Certainly, COVID elevated that with digital care delivery.”
This notion of healthcare consumerism has been around for decades, with the first mention of the concept dating all the way back to the 1930s. But more recently with the implementation of the Affordable Care Act (ACA), healthcare consumerism took on a newer meaning, one in which patients have more access to healthcare information.
“You have non-traditional industries delivering care such as payers and pharmacies, and doing it sometimes better, faster, and at a lower cost,” Lebrew stated. “So the concept of consumerism has been here for many years. Changes in healthcare including the Administrative Simplification of 1996 and ACA precipitated that, putting information in the patient's hands and empowering the patient, creating broader capabilities and access points.”
New initiatives like hospital price transparency and patient financial responsibility are only supporting the healthcare consumerism model, putting pressure on hospitals and health systems to revamp their financial experience and patient collections strategies. Otherwise, organizations will fall behind.
“Having transparency and real time access to information, particularly your own records, has become a standard and people expect that. The sign of the times is here, and we've been headed down that path for a long time,” LeBrew said.
University Hospitals has been aware of the shift in the healthcare environment and has already started on strategies to optimize patient financial experience in an effort to better serve patients and ensure a smooth revenue cycle—two goals that are closely linked, according to research.
Last year, the health system crafted a patient financial bill of rights that now includes 10 tenets they believe patients are entitled to, including sending bills in plain English, never sending a surprise out-of-network bill, and offering a stable network of providers.
But that is just the tip of the iceberg when it comes to University Hospitals’ plans to improve the patient financial experience.
“We play a big part in the digital consumer journey,” LeBrew explained. “We're very focused on ease of access including seeking, accessing, getting, and continuing care with advanced verification and communication with the patient to help prepare for planned services. One change coming, in particular, outside of price transparency is surprise billing, which will be in effect in 2022. Then, financial navigation as a service to patients. And that's going a little deeper than traditional norms around coverage, communication, coordination as well as financial assistance.”
Additionally, the health system has recently focused on consumer insights and offerings, LeBrew shared.
“We're really focusing on realigning our organization around consumer and family through intentional design to identify opportunities and develop services and solutions that better address health needs and result in exceptional business experience,” the revenue cycle leader explained. “In that strategy, some of the initiatives that we're focused on, much like many providers are, are price transparency, consumer segmentation, and customization with our interactions with patients.”
Creating a persona to optimize experience
When it all boils down, a consumer-focused revenue cycle strategy mirrors the clinical experience, LeBrew stated.
“It’s very basic. The business journey must mirror the clinical journey. The patient wants you to know them. They want you to know why they're here, what their history is, what is needed to do to take care of them and keep them healthy—clinically and financially. That's really the persona. If you apply that in the financial journey, it's no different,” LeBrew said.
“Know me. If I'm in good financial status, give me the benefit of the doubt. If I haven't paid the bill, help me and know how best to qualify them and their options,” LeBrew emphasized.
University Hospitals is already applying this philosophy to patient statements, which are engineered to guide individual patients to the best way for them to pay their bills based on their billing history and some predictive analytics.
“Because we know our patients we offer wide variety of support and leverage technology and analytics to guide patients appropriately.”
Leveraging technology
Technology has been key to helping create personas for more customized financial experiences. Predictive analytics from RevSpring, for instance, are gathering an enormous amount of patient data to suggest the pathway that will result in the best outcome—a patient paying their bill the way they are comfortable.
University Hospitals is also leveraging robotic processes, such as interactive voice response (IVR) to streamline customer service when a patient prefers to call in, and has established a digital portal with electronic consolidated statements for those who prefer to pay online.
“We're seeing an increase in that self-service aspect of their financial journey, whether it's price estimation or paying a bill in full or setting up their own payment plans and setting up reminders,” LeBrew commented. “We're also seeing a huge increase in our IVR payments. Now, we're looking at leveraging touchless payments.”
But as much as technology has helped to optimize the financial experience at University Hospitals, especially since the health system is processing such a large number of claims each day, revenue cycle management is still a deeply human process, LeBrew stated.
“Intuitive navigation for patients is really important and thinking about a digital front door to your organization that allows the patient to access, whether it's care or understanding financial impact, is really important,” the revenue cycle leader asserted.
“Basic things like convenience and simplicity are really important. Thinking about price transparency and the transformation it's going to have in healthcare, it is important now more than ever to change the paradigm of how you manage customer service.”
LeBrew also advised organizations to “bring the care team together to understand the patient’s needs not just from a financial perspective but with a multidisciplinary team.”
“We have a much more sophisticated consumer,” LeBrew said. “Thinking about solutions, support, and services to meet the patient's need will be really important in that effort. And then, helping your caregivers culturally to understand their role in how they can help the patient.”
“In the old days it was, ‘I'm a financial counselor and I talk to the patient about finances,’ and, ‘I'm a caregiver and I am a clinical caregiver only.’ That's no longer true. Everybody plays a role with a patient, whether it's digital communication, telehealth, or in-person,” LeBrew concluded. “We are all helping the patient understand and we do that is as much in advance of the service as possible to make their experience better and to really empower them in their decision-making and their financial outcomes.”
