Yale New Haven Health Streamlines Patient Billing Experience

Millions of patients present at Yale New Haven Health each year because they are sick, want to manage their chronic conditions, or simply have a healthcare-related need. With such a large volume of patients, Connecticut’s leading health system has excelled at meeting those clinical needs in their community.

The health system’s flagship hospital Yale New Haven Hospital has been ranked among the best facilities according to US News & World Report, while the systems four other hospitals and medical groups have also been recognized for excellent care or accredited by the top industry groups.

The quality of clinical care is at the heart of patient satisfaction and experience. But increasingly, the patient billing experience has been a critical factor in determining just how well a provider treats its patients.

“There's always the financial aspect of their care and because the cost to the patient has increased over the last five to seven years, patients are much more aware and concerned about what the financial expectation is and how much it's going to cost to them after they receive a service,” explains Sharlene Seidman, vice president of patient financial services at Yale New Haven Health.

More patients are enrolled in health plans with a high deductible, causing the burden of the deductible to rise significantly. In fact, Kaiser Family Foundation reports that the burden has increased by 111 percent over the last decade, considering both the number of people in high-deductible plans (83 percent) and deductible amounts (average of $1,644 for a single person) by 2020.

This isn’t just a patient problem, though. Research has shown that the more patients owe out of pocket for healthcare, the harder it is for providers to collect on medical bills.

Providing a high-quality patient billing experience around a clinical encounter has become not only important for patient satisfaction but also the bottom line.

“We've been focused on making sure that they understand how their insurance works and how they may be owing a cost of the service once their insurance processes it,” Seidman recently told RevCycleIntelligence.

“Then, on the back-end, once that balance becomes apparent or a part of the patient's world, how do we engage with those patients to make it a very easy and simple process for them to get a communication that they owe a balance, understand what that balance is, and then either quickly and easily pay that or perhaps set up a payment plan or even obtain information on any financial assistance that we can provide to them,” Seidman continued.

Yale New Haven Health has already taken several steps to improve that front-end experience —what happens before and when a patient comes in for care—by implementing a patient portal that provides personalized cost estimates, among many tasks.

The health system also does outreach through phone calls with patients so they understand their insurance benefits, know when a procedure is scheduled, and how much they may owe for that service based on verified insurance information, including how much they still owe for their deductible.

For the back end of the patient billing experience though, Yale New Haven Health is engaging in a new, strategic outreach effort to ensure patients understand their medical bills and that the organization gets paid for services rendered.

“We know that not all of our patients want to have the exact same experience. Some people want to receive a paper bill in the mail. Some people want to receive a text message. Some people want to log into a portal. Some people want to receive an email,” Seidman stated.

“Knowing what communication works best for each patient is what we're going to be exploring with Cedar and using their technology to help us so that we can get the patient the information quickly and in the way that they will respond,” Seidman added regarding Yale New Haven Health’s latest partnership with patient engagement technology company Cedar.

With the technology, Yale New Haven Health intends to understand “how to engage specific populations of people based on algorithms,” Seidman explained.

For example, the technology will be able to identify engagement trends, including what type of patient prefers a paper medical bill and who is more likely to respond to a text asking for payment. Seidman anticipates this technology to streamline the patient billing experience while helping the organization get paid sooner. But it is not the silver bullet for every patient.

“Technology is not the solution for every function or for every person,” Seidman stated. “Knowing what technology can solve for us and then leaving us with those people who might need a live person to talk to or to get them engaged is where we'll use our human resources.”

Healthcare is still a very human experience despite all the gadgets and equipment clinicians use to administer care. That needs to translate to the patient billing experience as well.

Seidman is making sure that the patient financial services team is equipped with the information and communication skills necessary to discuss billing and insurance with patients.

“We started a cultural transformation in 2019,” Seidman explained. “And what we've done is create a service excellence program where we train, practice, and monitor the behaviors that we're using when we're talking to a patient.”

The program resembles a typical customer service class or lesson, but Seidman underscored the sheer power of just being able to provide a good explanation to a patient using everyday language. This approach has not only increased confidence among staff to solve patient billing problems but also identify ways to reduce how many touchpoints patients have with the organization’s staff.

“I don't want to have you talk to six different people to get all of your questions answered, but maybe one person can coordinate for all of those six people and get you what you need,” Seidman said. “So, we have, in addition to technology and training people how to do their work, we train on the how, and that's what we call super service behaviors and it's really taken off.”

Yale New Haven Health is still undergoing this cultural transformation but Seidman and her team are measuring the success of the patient billing experience project in terms of dollars collected and how soon that money is reaching the organization.

Additionally, the organization is measuring its patient billing experience success based on net promoter scores.

“Lots of organizations send out Press Ganey surveys that measure patient satisfaction, but that's for your clinical experience,” Seidman said. “We use patient satisfaction surveys to ask our patients how we are doing specifically on revenue cycle functions.”

“The surveys that we sent out are just on your financial experience. So we're hoping that through better engagement and easier adoption that we will also improve our net promoter score,” Seidman continued.

Net promoter scores are more indicative of patient loyalty, not just patient satisfaction, according to anecdotal evidence. Higher net promoter scores indicate that patients are more likely to come back for services and, as the term suggests, promote the organization to their peers.

And data shows that even just a 5 percent increase in customer retention has been linked to more than a 25 percent increase in profit.

As deductibles and out-of-pocket costs continue to increase, leveraging both technology and human resources to boost metrics like net promoter scores will become very more vital to healthcare operations.

Delivering a more personalized, seamless experience will need to happen not just during a clinical encounter but at every point the patient touches the organization, including patient billing and account resolution.