Providers to Focus on Patient Billing, Policy Heading into 2020

Patient billing and experience

Provider prices will continue to grow in 2020, prompting payers, policymakers, and patients to seek additional value from their care providers, HRI researchers projected. Provider organizations will need to leverage data and consumer segmentation to create positive patient billing experiences in the new year.

“Research conducted by HRI concluded that consumer segments valued different features related to payment and billing, with, say, millennials much more likely to ask providers for discounts on the price of a visit, and more affluent patients much less interested in using retail pharmacy apps,” they wrote in the report. “Healthcare organizations that carefully segment their consumer populations and learn their preferences may be able to turn a pain point—billing and payment—into a positive experience that leads to return visits and good word-of-mouth.”

Provider organizations should also consider establishing a value line to optimize patient billing experiences, researchers advised.

As deductibles steadily increase, having a line of product or service offerings at different price points can help organizations grow in an increasingly consumer-centric industry. Traditional healthcare organizations should consider partnering or acquiring firms that already deliver value to the uninsured and underinsured while generating a profit, researchers stated.

Regulation and policy

Regulation is likely to be more important than legislation in 2020, industry experts told HRI. In such a divisive political climate, policymakers are highly unlikely to pass major healthcare reform, which will place greater emphasis on policy and regulation coming from federal agencies.

Provider organizations have already seen major regulations come from agencies in 2019. For example, the administration finalized new hospital price transparency requirements and additional tariffs on Chinese imports this year much to the dismay of providers.

HRI researchers advised provider executives to pay attention to Medicaid reforms if Republicans win the presidency again. The Republican administration is set on transforming Medicaid using work requirements, additional eligibility reviews, and other efforts that may lead to reduced Medicaid enrollment and, therefore, greater uncompensated care costs for providers.

Regardless of who wins the presidency, provider executives should continue to invest the infrastructure needed for value-based care implementation, HRI researchers added. Value-based care has bipartisan support, meaning policy and regulation will continue to support this transition away from fee-for-service.

Forward-thinking organizations should also start to incorporate a social determinants of health strategy into their value-based care plans considering CMS and tax policies have already hinted at the government’s support for such activities.

Healthcare mergers and acquisitions

Mergers and acquisitions (M&A) is not a new trend in healthcare but HRI researchers predicted organizations to take their deals abroad in 2020.

About 40 percent of the largest for-profit providers and 100 percent of the largest tax-exempt providers have a global presence, HRI data showed. These percentages may rise in 2020 as 60 percent of the for-profit and 100 percent of the tax-exempt providers seek innovation activity, such as investment funds, research centers, innovation platforms, and startups.

These global M&A deals can help providers grow their missions, bolster technology use, and leverage new business models. However, HRI researchers advised provider organizations to be aware of tax and workforce issues.

“US-based healthcare organizations with operations abroad may find themselves in the middle of shifting regulations and laws around taxation as nations grapple with the question,” they wrote in regard to new tax concerns over the digitalization and globalization of business. “Unilateral measures, which some countries have adopted or are considering, would subject many companies to double taxation, with a chilling effect on global investment and economic growth.”

Providers may face new M&A considerations, but that will not stop organizations from making new deals to align with new business models, HRI researchers added.

“In 2020, organizations will make strategic deals not to just grow larger but instead to expand into new identities with platforms anchored in value, innovation, customer experience and population health,” they explained. “As they weigh their options, health companies will need to ensure that the deals they pursue pass the sniff test of employers and consumers seeking more affordable care.”

For providers, these deals represent access to new technology, cost synergies, and the ability to make healthcare more affordable for patients. Being able to accomplish more than one of these deal goals will help providers to remain competitive in a more consumer-centric landscape, the report stated.

Workforce diversity

Employing a diverse workforce can not only improve company culture, but it could also increase patient loyalty and trust, according to HRI researchers.

“Only 8 percent of healthcare organizations responding to a 2019 global PwC survey said the primary objective of their diversity, equity and inclusion initiatives is to respond to customer expectations and needs,” they explained. “But that’s exactly what healthcare companies need to do as they compete harder to gain patient loyalty and trust—either directly or through employers and other partners seeking more value—on the road to improving population health.”

Providers who can fulfill their mission in a more inclusive and equitable manner will be more likely to realize growth opportunities in underserved populations and communities, they added.

Moving forward, HRI researchers advised providers to expand their workforce programs to include “specific inclusion and equity objectives that change how their mission is carried out.” Starting with an assessment that identifies inclusion and equity gaps that result in inequitable focus across the organization’s mission will help providers determine where a lack of diversity is impacting business.

Creating inclusion metrics and developing explicit behaviors that align with workforce diversity will also support provider organizations going into 2020.