Consumers Don't Pay Patient Financial Responsibility After Bad Experience

Consumers report a negative experience will dissuade them from paying full patient financial responsibility, according to the 2021 Healthcare Consumer Experience Study from Cedar. 

In the survey of more than 1,500 patients, 40 percent of respondents stated that they are dissatisfied with the interactions with their payer when inquiring about a bill, and another 40 percent are not satisfied with provider billing. 

The survey reports that medical bills are a source of anxiety and frustration for patients, affecting their financial experience. Over half of the respondents say paying a medical bill is stressful. 

Specifically, 53 percent of respondents find understanding their plan’s coverage and benefits stressful, and 53 percent find comprehending what they owe stressful. 

“The pandemic has enhanced digitization, and more value has been placed on the intuitiveness and ease of consumer experiences," Florian Otto, CEO, and co-founder of Cedar, explained in the report. "We have already seen this shift in industries such as retail and finance, but consumers are explicitly demanding more from their healthcare providers and payers.” 

“Bills continue to be a source of anxiety, stress and confusion due to the disjointed state of the industry. Healthcare is at a critical point where stakeholders must collaborate to improve digital experiences and transparency, or risk significant decline in consumer loyalty and financial outcomes.” 

The survey results suggest the primary driver of patient dissatisfaction in the billing and payment experience is a lack of clarity. 

Thirty-seven percent of patients will not pay their bill if they cannot understand the administrative experience, highlighting the need for better communication and bill transparency during their healthcare billing and payment experience. 

“Everybody thinks the patient is trying to get out of paying, but they actually want to pay,” Maxwell Kagan of Wellstar Medical Group, said in a public statement.

“What we owe them is the correct amount. We need to build processes, technology, and programs with the thought in mind that patients want to pay for their services. But they want to pay the correct amount, and they want different options for how they can pay for them.”

The survey showed that 58 percent of consumers tried to obtain information about out-of-pocket costs ahead of receiving care. However, close to 40 percent of those consumers said the information was inaccurate or difficult to locate. 

Healthcare providers' finances would benefit from ending surprise bills since consumers expect healthcare providers to be transparent when communicating about out-of-pocket cost. 

Six in ten consumers said they would like it if their healthcare provider offered the option to generate out-of-pocket costs online.

In addition, 79 percent of respondents reported wanting the option to pay a guaranteed out-of-pocket price before receiving care or at the time of the appointment.

The survey discovered that 90 percent of consumers consider healthcare providers posting pricing information on their website around expected out-of-pocket costs as “somewhat useful.” 

However, only one in three consumers state their healthcare providers offer these services “most of the time” or “always.”

Patients are not satisfied with payer-provider communication, emphasizing the damaging impact lack of communication between payers and providers has on the patient financial experience. 

Since providers and payers rarely talk with one another about a consumer’s plan of care, patients must bridge the gap by communicating with them separately. 

This additional task left on patients frequently leaves them frustrated and confused, with 31 percent of respondents reporting that they are dissatisfied with the coordination between their healthcare provider and payer.

The survey's overall results suggest patients want better explanations of bills, improved communication between provider and payer, accurate accounting of out-of-pocket costs, and consumer-friendly payment methods.